NPI | 1750624664 |
---|---|
Former Name | VIRGINIA ELAINE PEARSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.146318) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD460260) |
Enumeration Date | 2013-03-28 |
Last Update Date | 2020-01-14 |