NPI | 1720302383 |
---|---|
Former Name | COURTNEY JEAN WHITMORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX P6778) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2010-03-24 |
Last Update Date | 2013-08-29 |