NPI | 1730649864 |
---|---|
Former Name | JESSICA WALPOLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: OH 35.148664) |
Enumeration Date | 2019-03-24 |
Last Update Date | 2025-04-09 |