| NPI | 1215430079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX T6227) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 315322) | |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2022-05-24 |