| NPI | 1518586569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY C4585) |
| Additional Taxonomies | 2084N0600X (Licence: FL ME174303) |
| 2084N0600X (Licence: PA MD490335C) | |
| 2084N0600X (Licence: KY C4585) | |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2025-10-29 |