| NPI | 1790212108 |
|---|---|
| Former Name | CAROLYN GRACE AYERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: IN 11019296A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11019296A) |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2022-07-21 |