| NPI | 1639158462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 240414M60) |
| Additional Taxonomies | 2084N0600X (Licence: NY 2218321) |
| 2084N0600X (Licence: NJ 25MA07767500) | |
| 2084N0600X (Licence: CT 049506) | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2014-07-16 |