| NPI | 1235514936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 510122066) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2019-01595) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2020-12-14 |