Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 37847 | IA |
NPI | 1003074931 |
---|---|
Provider Name | Leyla Alexandra Best Bandenay |
First Address | Des Moines, IA 50309-1423 |
Second Address | Des Moines, IA 50309-1423 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2008 |
Last Update Date | 22/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003074931 | (05) | IA |