NPI | 1336408103 |
---|---|
Former Name | RENEE DAWN WHITE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX R7983) |
Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101257424) |
207L00000X Anesthesiology (Licence: TX R7983) | |
207L00000X Anesthesiology (Licence: MO 2019041276) | |
207L00000X Anesthesiology (Licence: WI 74769) | |
Enumeration Date | 2012-05-14 |
Last Update Date | 2024-12-23 |