| NPI | 1912106063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PR 17205) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 17205) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2008-11-18 |