| NPI | 1104281112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 35SI00553600) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NJ 5536) |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2019-05-09 |