| NPI | 1235889759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0102208172) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102208172) |
| 171000000X Military Health Care Provider | |
| Enumeration Date | 2022-03-27 |
| Last Update Date | 2026-10-14 |