| NPI | 1417362021 |
|---|---|
| Former Name | DIANA MARIE MATIRA MALBAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA10944700) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX R1818) |
| 208000000X Pediatrics (Licence: NY 290822) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2023-05-10 |