NPI | 1750493078 |
---|---|
Former Name | MICHELLE RAE BUTZER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD15263) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00034531) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2007-07-08 |