| NPI | 1689934002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X (Licence: SC 51378) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301100687) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301100687) | |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2022-02-16 |