| NPI | 1659662112 |
|---|---|
| Former Name | HOLLY COLLEEN AVENS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X (Licence: LA 303686) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: LA 303686) |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2024-08-06 |