| NPI | 1750770590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 69860) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 271890) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2022-06-15 |