NPI | 1073010567 |
---|---|
Former Name | AUDREY APRIL MARRAH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: IN 01085503A) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2018-04-10 |
Last Update Date | 2021-07-06 |