| NPI | 1023280021 |
|---|---|
| Former Name | MICHELLE JEAN BROCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: TX N6190) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 50011) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2015-09-16 |