NPI | 1801113220 |
---|---|
Former Name | JOANA LOUISE RILEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: MA 256327) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 256327) |
Enumeration Date | 2010-04-25 |
Last Update Date | 2016-08-25 |