| NPI | 1528166147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX N5966) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA07884700) |
| 2084N0600X (Licence: NJ 25MA07884700) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-06-27 |