| NPI | 1780001909 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL 135566)  | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 306735)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-26 | 
| Last Update Date | 2019-03-23 |