NPI | 1477949451 |
---|---|
Former Name | HOLLY VICTORIA MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: LA 310687) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-04-07 |
Last Update Date | 2022-08-22 |