| NPI | 1841259249 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 200401667)  | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 200401667)  | 
| Enumeration Date | 2006-03-23 | 
| Last Update Date | 2013-09-30 |