| NPI | 1790742211 |
|---|---|
| Former Name | KRISTINE LAUREN MIRON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5151013910) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2019-06-03 |