| NPI | 1871690024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 239039) |
| Additional Taxonomies | 2084N0600X (Licence: MA 239039) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2012-10-24 |