NPI | 1881128924 |
---|---|
Former Name | OLIVIA GIBSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA11105500) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX V5892) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-04-15 |
Last Update Date | 2025-03-03 |