Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 53-80728-111 | KS |
NPI | 1023760832 |
---|---|
Provider Name | Christina Brown |
First Address | Goddard, KS 67052-5211 |
Second Address | Wichita, KS 67208-3007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2022 |
Last Update Date | 23/01/2022 |