NPI | 1104032002 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: IA 30740) |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CA G54607) |
2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: NC 2005-0425) | |
Enumeration Date | 2007-05-15 |
Last Update Date | 2007-07-08 |