| NPI | 1932135639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 159786) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2020-05-05 |