NPI | 1588806343 |
---|---|
Former Name | MARLA KOSYDAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD173334) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60340307) |
Enumeration Date | 2009-03-25 |
Last Update Date | 2021-01-16 |