NPI | 1922531326 |
---|---|
Former Name | CATHERINE ELLIS MANNON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 63222) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TN 63222) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-04-04 |
Last Update Date | 2021-05-17 |