| NPI | 1497962799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 168083) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NY 168083) |
| 283Q00000X Psychiatric Hospital (Licence: NY 168083) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2016-02-29 |