| NPI | 1790103547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2018-00771) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.130261) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 316621) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 87807) | |
| Enumeration Date | 2014-03-30 |
| Last Update Date | 2025-05-02 |