| NPI | 1780612671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301077928) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301077928) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD440804) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2018-12-19 |