NPI | 1033345822 |
---|---|
Former Name | JACQUELINE S. BERRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: IN 01071071) |
Additional Taxonomies | 208000000X Pediatrics (Licence: KY 47602) |
Enumeration Date | 2009-06-07 |
Last Update Date | 2023-11-27 |