| NPI | 1194885442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: VA 0101241557) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2022-05-31 |