NPI | 1548355878 |
---|---|
Former Name | JENNIFER ANN REGO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA G57306) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G57306) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2019-11-12 |