NPI | 1962763573 |
---|---|
Former Name | NORRIECE LIANA GIBSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101261776) |
Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: VA 0101261776) |
Enumeration Date | 2012-05-31 |
Last Update Date | 2022-12-13 |