Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | #MT210469 | PA |
NPI | 1154767788 |
---|---|
Provider Name | Dr. Alexandra Marquez |
First Address | Philadelphia, PA 19104-4319 |
Second Address | Minneapolis, MN 55454-1450 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2013 |
Last Update Date | 09/08/2021 |