NPI | 1467556027 |
---|---|
Former Name | JENNIFER MAE CARR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 107980) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60167314) |
Enumeration Date | 2006-09-12 |
Last Update Date | 2014-12-01 |