| NPI | 1255794814 |
|---|---|
| Former Name | KATHLEEN DORA BONGIOVANNI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A174817) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML60657126) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2021-09-13 |