| NPI | 1659766483 |
|---|---|
| Former Name | JULIE MACNEIL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 62394) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AR E-11029) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2019-07-10 |