| NPI | 1386062727 |
|---|---|
| Former Name | DIANA HARTLEY MUNGALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX S2881) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 275455) | |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2019-10-08 |