NPI | 1730576851 |
---|---|
Former Name | VANESSA GARLICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A162350) |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: VT 042.0014081) |
Enumeration Date | 2015-04-16 |
Last Update Date | 2020-09-15 |