NPI | 1477101806 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MT219579) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT219579) |
Enumeration Date | 2019-08-28 |
Last Update Date | 2021-12-23 |