NPI | 1396038154 |
---|---|
Former Name | KATHLEEN MARIE PITTERLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: DE C2-0012722) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 262292) |
Enumeration Date | 2011-05-25 |
Last Update Date | 2020-05-21 |