NPI | 1487017257 |
---|---|
Former Name | JOHN RYAN DYESS |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: SC 88571) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-03-30 |
Last Update Date | 2022-09-15 |