NPI | 1063407732 |
---|---|
Former Name | TRACY D GUNTER-JUSTICE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01070168A) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2008026918) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA 35139) | |
Enumeration Date | 2005-09-19 |
Last Update Date | 2021-02-05 |