NPI | 1992098305 |
---|---|
Former Name | LAUREN KATE DELOACH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: TN DO3720) |
Additional Taxonomies | 208000000X Pediatrics (Licence: KY 03660) |
Enumeration Date | 2011-05-17 |
Last Update Date | 2020-09-17 |