| NPI | 1578854030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0805X (Licence: CT 54243) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 266789) | |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2017-05-10 |