NPI | 1871904292 |
---|---|
Former Name | KELLY MARIE RODA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 69595) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-05-20 |
Last Update Date | 2021-09-22 |