| NPI | 1225599707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0805X (Licence: CA 20A24302) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10068083) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX T3123) | |
| 2084P0805X (Licence: GA 95510) | |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2025-10-13 |