| NPI | 1104385046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2023018879) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2084P0805X (Licence: MO 2023018879) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2023-10-05 |