| NPI | 1588958300 |
|---|---|
| Former Name | DIANA RAE DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: VA 0101252356) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101252356) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2023-03-04 |