NPI | 1295113785 |
---|---|
Former Name | ALLISON SUTHERLAND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WV 3297) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-05-15 |
Last Update Date | 2018-07-23 |