NPI | 1275797565 |
---|---|
Former Name | VALERIE TACKABURY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MI 4301097836) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301097836) |
Enumeration Date | 2008-07-15 |
Last Update Date | 2014-07-08 |