| NPI | 1801230644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CT 56547) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CT 56547) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME134792) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2022-10-07 |