Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | E-13623 | AR |
N | 208000000X | Pediatrician | W-13623 | AR |
NPI | 1881076248 |
---|---|
Provider Name | Aixa Milagros Gonzalez Garcia |
First Address | Little Rock, AR 72225-1418 |
Second Address | Little Rock, AR 72202-3500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2015 |
Last Update Date | 02/08/2021 |