Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 1810 | NE |
NPI | 1003266073 |
---|---|
Provider Name | Meshva Akwalia |
First Address | Edwards Afb, CA 93524-0001 |
Second Address | Edwards Afb, CA 93524-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2016 |
Last Update Date | 05/02/2020 |