NPI | 1356761639 |
---|---|
Former Name | JESSICA VAN LENGERICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 64350) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-04-24 |
Last Update Date | 2019-08-15 |