| NPI | 1982966461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101254948) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101254948) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2023-09-25 |