NPI | 1134411135 |
---|---|
Former Name | JUDTIH MAREK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: MN 56454) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2011-05-09 |
Last Update Date | 2014-10-20 |