| NPI | 1164711040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 35.123358) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 57.019309) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.123358) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 47257) | |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2017-01-19 |