NPI | 1245765148 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 81081) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: WI 81081) | |
Enumeration Date | 2017-04-27 |
Last Update Date | 2023-04-26 |