NPI | 1851513436 |
---|---|
Former Name | CALLEY A. KENNEDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MN 51175) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125050402) |
208000000X Pediatrics (Licence: WI 52074-020) | |
Enumeration Date | 2007-05-03 |
Last Update Date | 2009-07-02 |