| NPI | 1780066985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: PA MD470654) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2020-09-02 |