NPI | 1972097210 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: FL ME169609) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2018016195) |
Enumeration Date | 2018-06-20 |
Last Update Date | 2024-08-15 |