| 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 |