| NPI | 1750953535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 36003) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT223481) |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2026-07-01 |