NPI | 1578854030 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (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 |