NPI | 1588878391 |
---|---|
Former Name | RUBY SIDDIQUI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CA 50414) |
Enumeration Date | 2007-05-10 |
Last Update Date | 2007-07-08 |