| NPI | 1164404174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WI 69377) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: LA MD200095) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2018-08-07 |