| NPI | 1629261052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 51253) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-052862) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 125-052862) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO 51253) | |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2012-06-15 |