Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 306473 | LA |
N | 2080P0208X | Pediatric Infectious Diseases | 306473 | LA |
NPI | 1497173603 |
---|---|
Provider Name | Dr. Monika Leah Dietrich |
First Address | New Orleans, LA 70112-2632 |
Second Address | New Orleans, LA 70112-2632 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2014 |
Last Update Date | 07/07/2021 |