| NPI | 1386871614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 59805) |
| Additional Taxonomies | 2084N0600X (Licence: MN 59805) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2022-01-13 |