Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | 29948 | SC |
Y | 2080P0216X | Pediatric Rheumatologist | 29948 | SC |
NPI | 1427253897 |
---|---|
Provider Name | Lara Mae Hourani Huber |
First Address | Greenville, SC 29601-2842 |
Second Address | Greenville, SC 29615-3593 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2007 |
Last Update Date | 25/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
299484 | (05) | SC |