| NPI | 1669453965 |
|---|---|
| Former Name | VITASTA SENGAL BAZAZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD035564-L) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2007-07-08 |