Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | ME101800 | FL |
NPI | 1851508857 |
---|---|
Provider Name | Kristina M Wiers-Shamir |
First Address | Miramar, FL 33025-3925 |
Second Address | Boca Raton, FL 33431-6421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 17/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000345100 | (05) | FL |