NPI | 1023093986 |
---|---|
Former Name | WENDY HICKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TN 2580) |
Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: OK 4346) |
Enumeration Date | 2005-12-13 |
Last Update Date | 2016-12-06 |