NPI | 1255899035 |
---|---|
Former Name | EMMA BOESEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0102206388) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208D00000X General Practice (Licence: VA 0102206388) | |
Enumeration Date | 2019-03-11 |
Last Update Date | 2023-08-11 |