| NPI | 1972954402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101263933) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2023-07-27 |