| NPI | 1780805077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME141513) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101252012) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2019-11-19 |