NPI | 1932786118 |
---|---|
Former Name | SERENA BETH MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL ME168338) |
Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME168338) |
Enumeration Date | 2021-03-25 |
Last Update Date | 2024-06-21 |