| NPI | 1508843517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME124747) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NM 98-15) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2016-12-09 |