| NPI | 1245216126 |
|---|---|
| Former Name | KATHLEEN MARIE O'MARA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 67527) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01071046) |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: IN 01071046) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2021-08-03 |