NPI | 1609262849 |
---|---|
Former Name | KAYLA HAAG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: TX u0215) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OK 6817) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-04-14 |
Last Update Date | 2022-12-15 |