| NPI | 1720364086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 279171) |
| Additional Taxonomies | 101Y00000X Counselor |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: MO 2017015531) | |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2021-01-27 |