| 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 |