| NPI | 1255315628 |
|---|---|
| Former Name | DEBORAH ANNE BANAZAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MI 5101008530) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5101008530) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2023-06-29 |