NPI | 1316175953 |
---|---|
Former Name | CAELAN MARY JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: VA 0101248689) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101248689) |
Enumeration Date | 2009-06-22 |
Last Update Date | 2023-03-20 |