NPI | 1790147007 |
---|---|
Former Name | MEGHAN BETH COURBANOU |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MA 1018113) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208000000X Pediatrics (Licence: TX S1915) | |
Enumeration Date | 2016-03-25 |
Last Update Date | 2024-02-01 |