| NPI | 1538367479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME132077) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2011008203) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA BM6733807-F47) | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2021-07-22 |