NPI | 1508151648 |
---|---|
Former Name | KRISTA LYNN PENTA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD14656) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI LP02240) |
Enumeration Date | 2011-06-16 |
Last Update Date | 2015-05-19 |