| NPI | 1356684443 |
|---|---|
| Former Name | ELIZABETH BRADLEY JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2016-00062) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2016-09-01 |