| NPI | 1407141716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: PR 019937) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD454028) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME128806) | |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2018-03-15 |