NPI | 1831362078 |
---|---|
Former Name | TERESA MARY KATERI O'HERRON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: CT 57133) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 58030) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 57133) | |
Enumeration Date | 2008-04-09 |
Last Update Date | 2022-09-09 |