| NPI | 1114553120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 92934) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 92934) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 11748) | |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2022-08-09 |