| NPI | 1649611864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NE 31357) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 286901) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2022-07-21 |