| NPI | 1083903280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME122023) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 304186) |
| 208VP0000X (Licence: FL ME122023) | |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2020-09-30 |