| NPI | 1477571362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ME 015653) |
| Additional Taxonomies | 2084P0805X (Licence: ME 015653) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60650723) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2016-09-26 |