| NPI | 1770967549 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: CT 64082) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT208366) | 
| Enumeration Date | 2015-07-11 | 
| Last Update Date | 2021-09-07 |