| NPI | 1376075705 |
|---|---|
| Former Name | DIAMOND ODELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 86098) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2020-06-22 |