| NPI | 1104545086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 116106) |
| Additional Taxonomies | 273R00000X Psychiatric Unit (Licence: IL 150.105517) |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2022-08-26 |