| NPI | 1134495872 |
|---|---|
| Former Name | JACQUELINE MARY BERNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: OH 35.134197) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MI 4301107121) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2021-04-15 |