| NPI | 1104351030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD210001481) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0091159) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101273955) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 70338) | |
| 208D00000X General Practice (Licence: WI 70338-20) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2022-03-16 |