| NPI | 1154471183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: KY 15112) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: KY 15112) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2021-09-03 |