NPI | 1194827378 |
---|---|
Other Name | MARY ELLEN MATASSO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 43170) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A79433) |
Enumeration Date | 2006-09-01 |
Last Update Date | 2007-07-08 |