NPI | 1578730990 |
---|---|
Former Name | LISA MARIE STUTIUS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MA 225657) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 225657) |
Enumeration Date | 2008-05-14 |
Last Update Date | 2011-06-26 |