| NPI | 1285609925 |
|---|---|
| Former Name | SHANDA BRAGG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D74876) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD035830) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2022-07-29 |