| NPI | 1396122065 | 
|---|---|
| Former Name | DANIELLE MARIE RICHARDSON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 63250) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2015-05-01 | 
| Last Update Date | 2018-07-03 |