NPI | 1427307164 |
---|---|
Former Name | CARLA RAYCHELLE BRYANT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MI 4301101320) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301101320) |
Enumeration Date | 2012-09-07 |
Last Update Date | 2017-08-07 |