NPI | 1740570910 |
---|---|
Former Name | CARRIE COYKENDALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MN 69918) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR.0053591) |
Enumeration Date | 2011-04-08 |
Last Update Date | 2023-12-14 |