NPI | 1619311214 |
---|---|
Former Name | ALYSSA CHARLOTTE DESOCIO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35-125773) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-04-25 |
Last Update Date | 2016-11-10 |