NPI | 1376002592 |
---|---|
Former Name | ABBY TERESE LEWIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: GA 92027) |
Additional Taxonomies | 208000000X Pediatrics (Licence: GA 92027) |
Enumeration Date | 2019-03-18 |
Last Update Date | 2025-07-01 |