| NPI | 1053386672 |
|---|---|
| Former Name | LISA ANN KIDD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NE 27321) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301063424) |
| 208000000X Pediatrics (Licence: SD 7503) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2014-04-02 |