| NPI | 1366901522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101270873) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2023-08-16 |