| NPI | 1154614469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60644738) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60644738) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 173365) | |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2018-05-10 |