NPI | 1861870115 |
---|---|
Former Name | MALLORY MCGINNIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: KS 04-40874) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-05-07 |
Last Update Date | 2024-03-27 |