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 |