| NPI | 1760548028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: FL ME90878) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: NY 261458) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2019-03-21 |