| NPI | 1164573002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 166749-01) |
| Additional Taxonomies | 283Q00000X Psychiatric Hospital (Licence: NY 166749-1) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2022-08-05 |