NPI | 1487142014 |
---|---|
Former Name | AMANDA CARROLL MIHALIK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 99797) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD61332378) |
Enumeration Date | 2018-04-30 |
Last Update Date | 2024-08-23 |