| NPI | 1720122104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 56625) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: OH 3560) |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2019-01-15 |