| NPI | 1417361163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 63809) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY IP1455) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2021-04-05 |