Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN9334022 | FL |
NPI | 1003363417 |
---|---|
Provider Name | Elsa Qayum |
First Address | Miami, FL 33176 |
Second Address | Miami, FL 33176 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2016 |
Last Update Date | 10/06/2020 |