NPI | 1700460060 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO 2024007290) |
Additional Taxonomies | 261QS1000X Clinic/Center Student Health |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-05-11 |
Last Update Date | 2024-06-04 |