| NPI | 1497249205 |
|---|---|
| Former Name | VICTORIA MARIE BROCKSMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: WI 72629) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 72629) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WI 72629) | |
| 208M00000X Hospitalist (Licence: WI 72629) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2022-08-30 |