| NPI | 1699125088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 30761) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 22807119) |
| 207R00000X Internal Medicine (Licence: WV 30761) | |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2021-10-18 |