| NPI | 1952430811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL 0059964) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 185936) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: FL ME0059964) | |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: FL ME0059964) | |
| 163W00000X Registered Nurse (Licence: NY 222304) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2025-10-07 |