| NPI | 1629364062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA 60751692) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ID O-0901) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2018-05-22 |