| NPI | 1104316868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV DO3092) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV SL1332) |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2022-06-28 |