| NPI | 1912032970 |
|---|---|
| Former Name | AMY MARIE GRIMES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ND 11884) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2008015156) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2023-06-14 |