NPI | 1588658447 |
---|---|
Former Name | KIMBERLY M TRACY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: IL 036089483) |
Additional Taxonomies | 174400000X Specialist (Licence: IL 036089483) |
Enumeration Date | 2005-09-07 |
Last Update Date | 2022-05-19 |