| NPI | 1063474013 |
|---|---|
| Former Name | CANDICE TATE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 059967) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036109593) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2010-09-29 |