| NPI | 1821015454 |
|---|---|
| Former Name | ELIZABETH G MONTGOMERY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 277616) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N00994) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2023-01-05 |