NPI | 1396867073 |
---|---|
Former Name | JANINE MARIE BAUMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 1999140465) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 065986) |
Enumeration Date | 2007-04-04 |
Last Update Date | 2019-06-18 |