NPI | 1972506814 |
---|---|
Former Name | JENNIFER KAY IRELAND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: WA MD60325791) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: SD 5430) |
Enumeration Date | 2005-05-24 |
Last Update Date | 2021-04-28 |