| NPI | 1104137678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C207968) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 49400) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ R71970) | |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2026-04-23 |