| NPI | 1447612619 |
|---|---|
| Former Name | LESLIE ANN DE LA FUENTE-CARRASQUILLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KS 04-42121) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2023036075) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2025-11-03 |