NPI | 1417416637 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA CA191478) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 320665) |
208D00000X General Practice (Licence: NY 320665) | |
Enumeration Date | 2019-03-18 |
Last Update Date | 2023-11-13 |