| NPI | 1710204987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CT 1.053250) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL32908) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MTL000406) | |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2016-08-25 |