| NPI | 1760064752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2022-02730) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC OJOG-HPS8G0) |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2022-10-06 |