| NPI | 1285631085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: LA 025564) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: LA 025564) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2024-11-11 |