| NPI | 1114239241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX Q1487) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: MA 244961) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2025-07-16 |