| NPI | 1902084791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NJ 25MB07211400) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MB07211400) |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2008-02-05 |