| NPI | 1275543365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NJ MA7185500) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NY 193989-1) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2015-07-10 |