| NPI | 1790703353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MN 10563) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: ND PAC0113) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2023-01-04 |