| NPI | 1710962089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 279888) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WI 45256) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CT 51875) | |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2021-05-13 |