| NPI | 1770105041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 97996-20) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 76794) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 262219) | |
| Enumeration Date | 2020-05-10 |
| Last Update Date | 2026-09-15 |