| NPI | 1912380932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CA A167907) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OK 31432) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2020-07-28 |