| NPI | 1295360782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: TX 0000000) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2020-03-05 |
| Last Update Date | 2020-03-05 |