| NPI | 1104910439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 75806) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 75806) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2012-12-19 |