| NPI | 1023404811 |
|---|---|
| Former Name | ANNIE W BLEDSOE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ID M-14080) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 10077801-1205) |
| 208000000X Pediatrics (Licence: UT 10077801-8905) | |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2018-07-19 |