NPI | 1235422429 |
---|---|
Former Name | GENALYNNE CARWILE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC 206-00815) |
Enumeration Date | 2011-05-19 |
Last Update Date | 2016-05-18 |