| NPI | 1679635221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WV 19898) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WV 19898) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2019-06-13 |