| NPI | 1740276658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 212808) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: MA 212808) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 11624) | |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2019-06-12 |