| NPI | 1629638812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 70259) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 125.075137) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 70259) | |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2022-08-12 |