NPI | 1477173326 |
---|---|
Former Name | LISA KATE SUSSMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: VA 101278362) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-04-21 |
Last Update Date | 2024-03-21 |