| 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 |