NPI | 1245617372 |
---|---|
Former Name | ALESE HARRIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2018-00447) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 210682) |
Enumeration Date | 2015-04-27 |
Last Update Date | 2018-07-18 |