| NPI | 1821594789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD213888) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2021-03394) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME158278) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T9992) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2023006337) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-31 |
| Last Update Date | 2024-04-05 |