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