| NPI | 1770115289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: VA 0110007317) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2021-03-03 |