| NPI | 1124049713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NY 182272) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NY 182272-1) |
| 208000000X Pediatrics (Licence: NY 182272) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2013-03-26 |