| NPI | 1649261116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00028535) |
| Additional Taxonomies | 2084P0805X (Licence: WA MD00028535) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2012-01-11 |