| NPI | 1952765174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: AR E-12700) |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health (Licence: TX BP10056556) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2023-10-18 |