| NPI | 1619936622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 041088) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 154247) |
| 2084P0805X (Licence: CT 041088) | |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2010-05-12 |