| NPI | 1730473885 |
|---|---|
| Former Name | KIMBERLY BOUCHARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA A148236) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A148236) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2025-12-04 |