NPI | 1225539513 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 285206) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 6141861) |
Enumeration Date | 2018-02-22 |
Last Update Date | 2022-09-09 |