| NPI | 1912032103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 25322) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101048094) |
| 2084P0805X (Licence: WV 25322) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2022-02-17 |