| NPI | 1508421405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME162404) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX U5214) |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2026-01-12 |