| NPI | 1306053285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 246269) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NY 246269) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2012-09-05 |