| NPI | 1902060486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD440784) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MT193237) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT193237) | |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2012-11-02 |