| 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 |