| NPI | 1528378460 |
|---|---|
| Other Name | JACK GILLEAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A141657) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0054348) |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2021-10-20 |