| NPI | 1124559497 |
|---|---|
| Former Name | MIRA YAZIGI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA10833700) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2020-06-03 |