| NPI | 1730166075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX F3402) |
| Additional Taxonomies | 2084P0805X (Licence: TX F3402) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2021-10-20 |