NPI | 1871913129 |
---|---|
Former Name | LEISEL SAMANTHA MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 83457) |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: GA 83457) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-04-24 |
Last Update Date | 2021-05-26 |