NPI | 1336657725 |
---|---|
Former Name | KSENIA FREEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 312794) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101273795) |
Enumeration Date | 2018-01-19 |
Last Update Date | 2023-10-30 |