| NPI | 1184875692 |
|---|---|
| Former Name | COLETTE D WAITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AK 8073) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME 107882) |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2021-09-22 |