NPI | 1558535781 |
---|---|
Former Name | KARLA HICKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35097568) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.097568) |
Enumeration Date | 2008-04-18 |
Last Update Date | 2022-11-23 |