| NPI | 1306953294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: FL ME103729) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO 2000169536) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA C53585) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CA C53585) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2016-10-05 |