| NPI | 1205271988 |
|---|---|
| Former Name | VANESSA GRACE LAGON PANIZALES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OH 35.127476) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A149188) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX R2704) | |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2018-02-02 |