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1972022259
IRADA WATTANAVITUKUL
SHERMAN OAKS, CA
NPI
1972022259
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2017-09-18
Last Update Date
2019-06-11
Business Address
IRADA WATTANAVITUKUL
13130 BURBANK BLVD
SHERMAN OAKS, CA 91401-6037
Phone number: 818-781-0360
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Mailing Address
IRADA WATTANAVITUKUL
13130 BURBANK BLVD
SHERMAN OAKS, CA 91401-6037
Phone number:
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