NPI | 1003566530 |
---|---|
Former Name | BRONWYN LANE SCOTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 74710) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 32522) |
Enumeration Date | 2022-03-27 |
Last Update Date | 2024-12-17 |