| NPI | 1982066502 |
|---|---|
| Former Name | EVAN AMELIA MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2019015017) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2016022001) |
| 208000000X Pediatrics (Licence: KS 04-43587) | |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2023-11-16 |