NPI | 1598110215 |
---|---|
Former Name | CANDICE G WILLIAMS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CT 63814) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-05-02 |
Last Update Date | 2023-02-13 |