Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 058180 | GA |
NPI | 1457412165 |
---|---|
Provider Name | Dr. Dafina Menjeiwie Good |
First Address | Atlanta, GA 30329-2304 |
Second Address | Atlanta, GA 30329-2304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 08/07/2007 |