NPI | 1962720144 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX N4425) |
Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: TX N4425) |
Enumeration Date | 2010-05-12 |
Last Update Date | 2025-04-07 |