Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | MD60367236 | WA |
NPI | 1194041707 |
---|---|
Provider Name | Dr. Agne Taraseviciute |
First Address | Los Angeles, CA 90027-6062 |
Second Address | Los Angeles, CA 90027-6062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2010 |
Last Update Date | 04/01/2019 |