Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | A104511 | CA |
NPI | 1154609162 |
---|---|
Provider Name | Jacquelyn Lisa Baskin-Miller |
First Address | Chapel Hill, NC 27599-7236 |
Second Address | Los Angeles, CA 90027-6062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2011 |
Last Update Date | 13/08/2019 |