NPI | 1699118018 |
---|---|
Former Name | RACHEL BETHANY WALLACE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D84102) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-04-16 |
Last Update Date | 2018-12-27 |