| NPI | 1629382114 |
|---|---|
| Former Name | ELIZABETH RATNAMALA BENJAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NY F401255) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401255) |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2010-07-28 |