NPI | 1164625877 |
---|---|
Former Name | ELIZABETH A RISCOE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: KS 04-29630) |
Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MO 2013022095) |
Enumeration Date | 2007-06-08 |
Last Update Date | 2014-12-04 |