NPI | 1073933883 |
---|---|
Former Name | BETHANY COLWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX S8111) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2014019471) |
Enumeration Date | 2014-04-18 |
Last Update Date | 2021-04-06 |