| NPI | 1376868356 |
|---|---|
| Former Name | ELIZABETH PEACOCK-VILLADA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 254101) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2016-12-16 |