NPI | 1528301587 |
---|---|
Former Name | JENNY ADELE JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: NY 287995-1) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 287995) |
Enumeration Date | 2013-03-28 |
Last Update Date | 2019-03-12 |