| NPI | 1780638577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME00647727) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: KY 49965) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2017-06-19 |