NPI | 1134206147 |
---|---|
Former Name | MYRA LOUISE CRANSHAW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: DC MD21669) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0051418) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2007-07-08 |