| NPI | 1790063899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 56303) |
| Additional Taxonomies | 2084N0600X (Licence: CT 56303) |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2018-02-06 |