| NPI | 1104806801 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 045217)  | 
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: GA 045217)  | 
| Enumeration Date | 2006-01-19 | 
| Last Update Date | 2012-09-10 |