| NPI | 1073774345 |
|---|---|
| Former Name | ELIZABETH JEANNE-ANNE WALLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA MD.204558) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL 29699) |
| 208000000X Pediatrics (Licence: TN 54988) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2019-02-04 |