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 |