NPI | 1346561255 |
---|---|
Former Name | JENNIFER LINCOLN GILLIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 53662) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2010-06-15 |
Last Update Date | 2021-05-20 |