| NPI | 1508051517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 282958) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VT 0420011252) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2021-05-05 |