| NPI | 1922494608 |
|---|---|
| Former Name | SASHA JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 81012-20) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME169341) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2024-07-19 |