NPI | 1861479438 |
---|---|
Former Name | LESLIE BARBARA GALLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME131646) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 104662) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD051907L) | |
Enumeration Date | 2005-12-27 |
Last Update Date | 2021-07-14 |