NPI | 1013355312 |
---|---|
Former Name | LOREEN PHYLLIS CAROL FOURNIER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD15513) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301115639) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI LP02868) | |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI CLP02868) | |
Enumeration Date | 2013-06-07 |
Last Update Date | 2021-06-03 |