| NPI | 1275646135 |
|---|---|
| Former Name | JUDY ROSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD21213) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00022802) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2014-10-03 |