NPI | 1932794328 |
---|---|
Former Name | ALANA TUCKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101276472) |
Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101276472) |
Enumeration Date | 2021-03-08 |
Last Update Date | 2024-07-31 |