| NPI | 1952557647 |
|---|---|
| Former Name | CAROLYN JEAN GONTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WI 63706) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MN 53895) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2022-02-09 |