NPI | 1013275312 |
---|---|
Former Name | KRISTEN GAIL DIXON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA OS018245) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-04-25 |
Last Update Date | 2020-08-30 |