| NPI | 1972242097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 197985) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 338722) | |
| Enumeration Date | 2022-05-27 |
| Last Update Date | 2025-08-02 |