| NPI | 1861406480 |
|---|---|
| Former Name | SHEALYN DYNESE BAUDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101276779) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX L8278) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2024-03-21 |