| NPI | 1649581414 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A127035)  | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301096865)  | 
| Enumeration Date | 2010-06-27 | 
| Last Update Date | 2015-02-28 |