NPI | 1942793021 |
---|---|
Former Name | CELESTE GARLAND FRANCES BLACK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: DC MD049127) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT215235) |
Enumeration Date | 2018-06-12 |
Last Update Date | 2022-08-15 |