| NPI | 1518078963 |
|---|---|
| Former Name | KIYETTA H ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX M6492) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME93167) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-12 |