| 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) |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2025-06-20 |