NPI | 1053553750 |
---|---|
Former Name | KATHLEEN WIERTEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TX P1248) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2009-03-27 |
Last Update Date | 2015-07-30 |