| NPI | 1700152618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A141843) |
| Additional Taxonomies | 2084P0805X (Licence: NY 278671) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD207214) | |
| Enumeration Date | 2012-03-25 |
| Last Update Date | 2022-05-23 |