NPI | 1093134413 |
---|---|
Former Name | CAITLIN COLLEEN GALLAGHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: MT MED-PHYS-LIC-56360) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-04-14 |
Last Update Date | 2019-02-19 |