| NPI | 1205828209 |
|---|---|
| Former Name | CHRISTINA MARIE HICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 43725) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD423131) |
| 208000000X Pediatrics (Licence: KY TP280) | |
| 208000000X Pediatrics (Licence: MT 14692) | |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2021-12-21 |