NPI | 1710113089 |
---|---|
Former Name | NICOLE M SOSA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME 104043) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL ME104043) |
Enumeration Date | 2009-06-01 |
Last Update Date | 2022-02-15 |