NPI | 1962025825 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 329195) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA ETLL-991) |
Enumeration Date | 2020-05-26 |
Last Update Date | 2024-06-06 |