| NPI | 1568436020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 042-0012423) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: HI MD-4401) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2012-05-30 |