NPI | 1154701043 |
---|---|
Former Name | MINDY LEIGH AGIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.134547) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-06-04 |
Last Update Date | 2020-12-03 |