| NPI | 1588984538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 264440) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 48674) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 48674) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 264440) | |
| Enumeration Date | 2010-06-01 |
| Last Update Date | 2013-12-27 |