NPI | 1598206773 |
---|---|
Other Name | CHANTEL M KING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0102205686) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0116030469) |
Enumeration Date | 2017-03-20 |
Last Update Date | 2021-08-17 |