| NPI | 1659508679 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME108411) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 2084P0805X (Licence: FL ME108411) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: FL ME108411) | |
| Enumeration Date | 2009-06-17 | 
| Last Update Date | 2012-04-23 |