NPI | 1679762710 |
---|---|
Former Name | MARY GREAVER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME 102200) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN8941) |
Enumeration Date | 2007-10-15 |
Last Update Date | 2008-07-09 |