| NPI | 1619954096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 41661) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME126157) |
| 208D00000X General Practice (Licence: MN 41661) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2024-05-09 |