NPI | 1255777876 |
---|---|
Former Name | AMANDA DELONG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301102988) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301102988) |
Enumeration Date | 2013-05-22 |
Last Update Date | 2019-07-10 |