| NPI | 1912914706 |
|---|---|
| Former Name | JUDITH GAIL JEFFERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME128110) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN MD14311) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2023-03-20 |