NPI | 1720574411 |
---|---|
Former Name | MAILYN SANTANA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME151456) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN26230) |
Enumeration Date | 2018-07-05 |
Last Update Date | 2023-04-24 |