Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | DS036667 | PA |
NPI | 1356648471 |
---|---|
Provider Name | Elizabeth Ann Bilodeau |
First Address | Pittsburgh, PA 15261-0001 |
Second Address | Pittsburgh, PA 15261-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2011 |
Last Update Date | 17/08/2012 |