NPI | 1225322183 |
---|---|
Former Name | DIANA GRACE NEWSOM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: VA 010127929) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A150668) |
208000000X Pediatrics (Licence: MD D0077878) | |
Enumeration Date | 2011-06-07 |
Last Update Date | 2022-12-21 |