NPI | 1376779744 |
---|---|
Former Name | MARISSA L ANDRES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A118959) |
Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA A118959) |
Enumeration Date | 2009-05-29 |
Last Update Date | 2020-11-18 |