| NPI | 1417070400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA04530700) |
| Additional Taxonomies | 261QS1000X Clinic/Center, Student Health (Licence: NJ 25MA04530700) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2007-07-08 |