| NPI | 1124363098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 20A11417) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL UO3396) |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2012-12-04 |