| NPI | 1700907854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PR 9644) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: PR 9644) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2021-11-04 |