NPI | 1013188754 |
---|---|
Former Name | TRACEY ANN PERAZONE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: DE C1-0011343) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 258019) |
Enumeration Date | 2008-03-21 |
Last Update Date | 2015-06-10 |