| NPI | 1295716124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME053185) |
| Additional Taxonomies | 2084P0805X (Licence: FL ME 053185) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2010-09-20 |