NPI | 1962894691 |
---|---|
Former Name | EMILY ELIZABETH JERNIGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: FL 20993) |
Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0102204576) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0102204576) | |
2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: VA 0102204576) | |
Enumeration Date | 2015-03-04 |
Last Update Date | 2024-05-22 |