| NPI | 1154637015 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR md162855) | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR 151340) | 
| Enumeration Date | 2010-08-29 | 
| Last Update Date | 2014-03-03 |