| NPI | 1174262984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry (Licence: NY 906369002) |
| Additional Taxonomies | 1744P3200X Specialist Prosthetics Case Management |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2024-04-30 |