NPI | 1306069471 |
---|---|
Former Name | SARA SHELBY BOBLICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301083568) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301083568) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301083568) | |
Enumeration Date | 2007-04-10 |
Last Update Date | 2012-02-06 |