| NPI | 1699008409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 053486) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME 94226) |
| 2084N0600X (Licence: FL ME 94226) | |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2025-04-01 |