| NPI | 1740306240 |
|---|---|
| Former Name | JUDITH KIKUE CENTERWALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 61296) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00031094) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2021-03-30 |