NPI | 1538714753 |
---|---|
Former Name | MARY ALEXANDRA LEWIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME168747) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 100891) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD210011694) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-08-05 |
Last Update Date | 2024-11-19 |