| NPI | 1710955646 |
|---|---|
| Other Name | N/A N/A N/A |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 44028) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME153564) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2023-12-06 |