NPI | 1174518427 |
---|---|
Former Name | CONSTANCE E MCMULLAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2005-01198) |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NC 2005-01198) |
Enumeration Date | 2005-09-13 |
Last Update Date | 2011-09-09 |