NPI | 1437470010 |
---|---|
Former Name | TRACI MICHELLE LIEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60334134) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2010-06-17 |
Last Update Date | 2013-05-14 |