| NPI | 1740395813 |
|---|---|
| Former Name | CAROL BOETTGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NM MD2009-0640) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: NM MD2009-0640) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2013-04-16 |