| NPI | 1104025758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: VA 0101246907) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: NY 232117) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: VA 0101246907) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 232117) | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2010-10-13 |