| NPI | 1750797783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 291142) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MN 109117) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 291142) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 22278) | |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2022-01-10 |