NPI | 1003903998 |
---|---|
Former Name | LISA JEANNE BRANCATO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MA 232582) |
Additional Taxonomies | 208000000X Pediatrics (Licence: SC 23933) |
Enumeration Date | 2006-10-10 |
Last Update Date | 2011-12-15 |