| NPI | 1114288198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA OS016866) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA OT014783) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT014783) | |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2021-06-03 |