| NPI | 1104035617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME113610) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MI 4301083122) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-09-01 |