NPI | 1083876643 |
---|---|
Former Name | LENORE REEVA C SIMANGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A121519) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NH 17235) |
Enumeration Date | 2008-06-25 |
Last Update Date | 2022-07-21 |