NPI | 1407920705 |
---|---|
Former Name | MICHELLE KOMOSA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA G64300) |
Enumeration Date | 2006-11-20 |
Last Update Date | 2007-07-08 |