| NPI | 1740506344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME173919) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 298422) |
| 208D00000X General Practice (Licence: VA 0101251169) | |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2025-05-30 |