NPI | 1063615474 |
---|---|
Former Name | KATHERINE GRACE VENABLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 53503) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MN 53503) |
Enumeration Date | 2007-06-06 |
Last Update Date | 2019-07-15 |