| NPI | 1912583808 |
|---|---|
| Former Name | LEONA VIDAMARIA VIVAS RAMOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 327898) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2024-06-07 |