NPI | 1942731807 |
---|---|
Former Name | HEATHER GROSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: OK 37147) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-03-22 |
Last Update Date | 2021-07-10 |