NPI | 1780048132 |
---|---|
Former Name | REBECCA K DAGO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IL 036157743) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036157743) |
Enumeration Date | 2016-04-12 |
Last Update Date | 2021-12-27 |