| NPI | 1225604176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL 9117419) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9114719) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2024-05-16 |