Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 078093 | GA |
NPI | 1083030548 |
---|---|
Provider Name | Juanita Neira Fresneda |
First Address | Atlanta, GA 30322 |
Second Address | Atlanta, GA 30322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2014 |
Last Update Date | 23/01/2018 |