| NPI | 1720511702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: TX T9509) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OK S082795972) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2022-10-10 |