| NPI | 1649255191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 40813) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 40813) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2016-01-15 |