| NPI | 1114375292 |
|---|---|
| Former Name | NICOLE PATRICE FERSZT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MI 4301117291) |
| Enumeration Date | 2016-05-30 |
| Last Update Date | 2019-08-09 |