| NPI | 1962780502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CT 062658) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MI 4301098793) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2022-09-30 |