| NPI | 1104200062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX U3956) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 01160228596) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2023-08-22 |