NPI | 1326274135 |
---|---|
Former Name | MICHELLE ANN CHRISCO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX P0253) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2009-06-08 |
Last Update Date | 2012-03-19 |