| NPI | 1184647802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME139462) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CT 026162) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2024-06-07 |