NPI | 1609142843 |
---|---|
Other Name | JULIE TEA CONRAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: WA A128531) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60573479) |
Enumeration Date | 2012-03-30 |
Last Update Date | 2025-05-06 |