| NPI | 1326433301 |
|---|---|
| Former Name | KATIE ANNE KENEALY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 75410-20) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 10100590-1205) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2021-07-21 |