| NPI | 1508025248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101255180) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: HI 5464) |
| 208000000X Pediatrics (Licence: VA 0101255180) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101255180) | |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2014-03-19 |