| NPI | 1205096625 |
|---|---|
| Former Name | CAITLIN MALLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD460920) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ME 018845) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2020-08-30 |