| NPI | 1710093653 |
|---|---|
| Former Name | THERESA MARIE MATUSZAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: VA 0101235178) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2023-02-15 |