| NPI | 1730560640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX S2469) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY R3862) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2020-07-23 |