| NPI | 1174919039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A170480) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 01081604A) |
| 208000000X Pediatrics (Licence: CA A170480) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WI 86136-20) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 34962999) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2025-11-05 |