| NPI | 1619289311 |
|---|---|
| Former Name | JACQUELINE L. ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MO 2015021019) |
| Enumeration Date | 2010-07-10 |
| Last Update Date | 2016-04-04 |