| NPI | 1255627469 |
|---|---|
| Professional Name | COLLEEN WALLACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DC MD500003331) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0116023955) |
| 208000000X Pediatrics (Licence: MD D78050) | |
| 208M00000X Hospitalist (Licence: MD D78050) | |
| Enumeration Date | 2011-06-26 |
| Last Update Date | 2026-05-07 |