Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A137741 | CA |
N | 111NI0900X | Internist | A137741 | CA |
Y | 207SG0201X | Clinical Genetics (M.D.) | ME113650 | FL |
N | 208000000X | Pediatrician | A137741 | CA |
NPI | 1790959294 |
---|---|
Provider Name | Dr. Willa Leanah Thorson |
First Address | Miami, FL 33136 |
Second Address | Miami, FL 33136-1012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2008 |
Last Update Date | 17/03/2018 |