| NPI | 1396857975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 40715) |
| Additional Taxonomies | 171W00000X Contractor (Licence: TX M3409) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-07-21 |