NPI | 1609032895 |
---|---|
Former Name | TARA CARMEN KUNKLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MO 2012029906) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125-050752) |
208000000X Pediatrics (Licence: IL 036122800) | |
Enumeration Date | 2008-08-06 |
Last Update Date | 2012-10-03 |