| NPI | 1649763079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA R-11299) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA R-11299) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2019-01-17 |