| NPI | 1225438963 |
|---|---|
| Former Name | VIVIANA CLAURE FORTI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA09899400) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2022-02-01 |