NPI | 1134783798 |
---|---|
Former Name | CHRISTINE CONNOLLY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2022039068) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-04-29 |
Last Update Date | 2022-10-03 |