NPI | 1013597582 |
---|---|
Former Name | COURTNEY KUSLER |
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101282440) |
Enumeration Date | 2021-04-09 |
Last Update Date | 2024-12-19 |