| NPI | 1336569599 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 176428) | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 282050) | 
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 281353-1) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA 477389) | |
| Enumeration Date | 2014-04-25 | 
| Last Update Date | 2022-04-22 |