NPI | 1710322896 |
---|---|
Former Name | PATRICIA ROSE BLEDSOE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: GA 82246) |
Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN |
208000000X Pediatrics (Licence: CA 20A14128) | |
208D00000X General Practice (Licence: GA 82246) | |
Enumeration Date | 2013-05-02 |
Last Update Date | 2023-04-21 |