NPI | 1306074729 |
---|---|
Former Name | JENNIFER KIM STIERWALT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI 16188) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2009-06-24 |
Last Update Date | 2023-07-19 |