| NPI | 1700064821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 281P00000X Chronic Disease Hospital |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A102373) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 250717) | |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2012-05-18 |