| NPI | 1861805004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 67774) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A155647) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2020-07-03 |