| NPI | 1750901534 |
|---|---|
| Former Name | CATHERINE EVE TISDALE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 89596) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2023-07-24 |