| NPI | 1396139671 |
|---|---|
| Former Name | SALLY MARTINEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WI 1396139671) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 66315-20) |
| 208D00000X General Practice (Licence: WI 66315-20) | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2020-09-15 |