NPI | 1962763359 |
---|---|
Former Name | ANN ADAIR CODY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: MN 59261) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-06-03 |
Last Update Date | 2018-08-21 |