| NPI | 1205363678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2022-01299) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MI 5101023400) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC 2022-01299) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2022-09-22 |