| NPI | 1366730020 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 5101019235) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101019235) | 
| Enumeration Date | 2011-07-15 | 
| Last Update Date | 2020-05-08 |