| NPI | 1750761151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 83781) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: KS 94-08646) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2019-08-26 |