NPI | 1154940575 |
---|---|
Former Name | MARYGAYLE ELIZABETH MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0102206920) |
Enumeration Date | 2020-04-15 |
Last Update Date | 2024-09-27 |