| NPI | 1457662256 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 279921)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT198306)  | 
| Enumeration Date | 2010-06-25 | 
| Last Update Date | 2019-07-10 |