| NPI | 1104358977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 070437) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 271443) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR DO203450) | |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2023-01-13 |