NPI | 1285832196 |
---|---|
Former Name | COURTNAY WILD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MO 2010015036) |
Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KS 0435661) |
Enumeration Date | 2007-07-03 |
Last Update Date | 2014-10-10 |