| NPI | 1871548313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 1017942) |
| Additional Taxonomies | 2084P0805X (Licence: FL ME146992) |
| 2084P0805X (Licence: PR 7744) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2024-08-07 |