| NPI | 1780977207 |
|---|---|
| Former Name | KATIE MARIE GREENE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 51676) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2022-08-29 |