NPI | 1306465406 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171000000X Military Health Care Provider |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101282957) |
Enumeration Date | 2020-04-09 |
Last Update Date | 2024-10-29 |