NPI | 1639574221 |
---|---|
Former Name | CAROL PATRICIA PINA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: DE C1-0012081) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.140477) |
208000000X Pediatrics (Licence: WV 30014) | |
Enumeration Date | 2014-10-26 |
Last Update Date | 2021-07-16 |