NPI | 1134324148 |
---|---|
Former Name | IRA PAULA YUSUP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A112875) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD431846) |
Enumeration Date | 2007-06-19 |
Last Update Date | 2020-07-01 |