| NPI | 1124515507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: NY 322581) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2024-03-01 |