| NPI | 1467771402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA 20A13208) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT013525) |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2015-05-12 |