| NPI | 1801097001 |
|---|---|
| Former Name | DIANA SOFIA GLACCUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME105239) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME105239) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2024-03-28 |