| NPI | 1568048684 |
|---|---|
| Former Name | SUE DIAMOND STAZETSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 94823) |
| Enumeration Date | 2021-03-19 |
| Last Update Date | 2024-06-25 |