Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD19841 | ME |
N | 208000000X | Pediatrician | MD2013-0581 | NM |
Y | 2080P0214X | Pediatric Pulmonologist | A136493 | CA |
NPI | 1174879738 |
---|---|
Provider Name | Irina Dralyuk |
First Address | Los Angeles, CA 90051-0717 |
Second Address | West Hollywood, CA 90048-1804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2012 |
Last Update Date | 13/04/2020 |