| NPI | 1003020496 |
|---|---|
| Former Name | ELIZABETH AMANDA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0015X Psychiatry & Neurology Psychosomatic Medicine (Licence: IA 41342) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology Psychosomatic Medicine (Licence: MA 249100) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2021-03-30 |