| NPI | 1366709396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX T0572) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 50944) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY TP192) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2025-07-18 |