NPI | 1679713259 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101272680) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 042-0012387) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 238545) | |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101272680) | |
Enumeration Date | 2009-02-23 |
Last Update Date | 2021-08-26 |