| NPI | 1215299193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0058260) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 252199) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2022-08-31 |