NPI | 1619169984 |
---|---|
Former Name | CAROLINA BONILLA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A104077) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA MT191785) |
2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX P6952) | |
Enumeration Date | 2007-08-10 |
Last Update Date | 2024-05-01 |