| NPI | 1629071402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: UT 172239-1205) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NV 5125) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2015-05-15 |