| NPI | 1639302078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME112727) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WI 72064) |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2022-10-18 |