| NPI | 1629630223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 35.145323) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57.247888) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2025-08-05 |