| NPI | 1659766269 |
|---|---|
| Former Name | CALISTA ROEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301113999) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2018-07-10 |