NPI | 1255673075 |
---|---|
Former Name | ALLISON TALBERT HICKEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MN 70473) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 270327) |
208000000X Pediatrics (Licence: IL 036.139944) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-03-19 |
Last Update Date | 2023-10-05 |