| NPI | 1336435122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MA 267729) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA OS017607) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA 0T014065) | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2020-11-08 |