| NPI | 1679815443 |
|---|---|
| Former Name | BROOKE MICHELE MINER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA 325714) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD465276) |
| 208000000X Pediatrics (Licence: IA 43249) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2021-05-11 |