| NPI | 1225323801 |
|---|---|
| Former Name | AUTUMN J. LANE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NJ 25MB09302100) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MB09302100) |
| 208000000X Pediatrics (Licence: NJ L0409069757844) | |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2019-07-08 |