| NPI | 1689622219 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NE 24380)  | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00018817)  | 
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA 36756)  | |
| Enumeration Date | 2006-05-05 | 
| Last Update Date | 2008-02-01 |