NPI | 1417165614 |
---|---|
Former Name | MEREDITH LEIGH FISHBANE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: IA MD-41814) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 231765) |
208000000X Pediatrics (Licence: PA MD429411) | |
Enumeration Date | 2007-05-19 |
Last Update Date | 2015-04-08 |