| NPI | 1336339191 |
|---|---|
| Former Name | BETH ERIN BLOOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: WV 24203) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV 24203) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2021-11-30 |