| NPI | 1629276662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME58742) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: FL ME58742) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2014-05-06 |