| NPI | 1154446680 |
|---|---|
| Former Name | SHANTA PEARL HENDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: MD D63367) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2008-02-07 |