| NPI | 1821267261 |
|---|---|
| Former Name | BETHANY MARIE FREEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0062502) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX L6273) |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2008-10-09 |