| NPI | 1760626550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 58591) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD452103) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 269967-1) | |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2016-10-06 |