| NPI | 1174900369 |
|---|---|
| Former Name | ANDREA MICHELLE OWEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX R7355) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2019-02-14 |