NPI | 1104313188 |
---|---|
Former Name | HILLARY KONSURE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE 2695) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NE 2695) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-16 |
Last Update Date | 2022-11-20 |