NPI | 1972834349 |
---|---|
Former Name | SARA CREAGER CHILDRESS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery (Licence: TX Q0044) |
Additional Taxonomies | 208600000X Surgery (Licence: TX BP10034423) |
2086S0120X Surgery Pediatric Surgery (Licence: MT 1972834349) | |
Enumeration Date | 2010-01-24 |
Last Update Date | 2023-11-27 |