| NPI | 1700535606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 1027021) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 1027021) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 1027021) | |
| Enumeration Date | 2022-03-20 |
| Last Update Date | 2026-08-25 |