| NPI | 1902819295 |
|---|---|
| Former Name | CARRIE FENTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101015020) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5101015020) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2021-01-05 |