| NPI | 1902252471 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301508725) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT218087) | 
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 125071550) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-13 | 
| Last Update Date | 2023-06-12 |