NPI | 1568049856 |
---|---|
Former Name | ELLEN MAE HENSLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2024-01860) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2021-03-24 |
Last Update Date | 2024-07-09 |