NPI | 1417942053 |
---|---|
Other Name | STACIE A COLWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MA 254910) |
Additional Taxonomies | 208000000X Pediatrics (Licence: VT 042-0010725) |
208000000X Pediatrics (Licence: NH 15974) | |
Enumeration Date | 2005-09-20 |
Last Update Date | 2014-07-18 |