NPI | 1740600402 |
---|---|
Former Name | CATHERINE DAVIS SHOLES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: SC 83694) |
Additional Taxonomies | 171000000X Military Health Care Provider (Licence: NE 28923) |
208000000X Pediatrics (Licence: NE 28923) | |
208D00000X General Practice (Licence: NE 28923) | |
Enumeration Date | 2014-04-22 |
Last Update Date | 2023-03-14 |