| NPI | 1548680259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 59963) |
| Additional Taxonomies | 2084P0805X (Licence: MN 59963) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2024-08-09 |