NPI | 1093498768 |
---|---|
Former Name | CHANNING FREEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 24-0339) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2023-08-09 |
Last Update Date | 2024-06-21 |