| NPI | 1629412150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY TP777) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MT203393) |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2018-08-22 |