Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | C-7262 | AR |
NPI | 1477654044 |
---|---|
Provider Name | Ms. Lee Antoinette Darville |
First Address | Pittsburgh, PA 15224-1334 |
Second Address | Pittsburgh, PA 15224-1334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 20/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
117596001 | (05) | AR |
E91735 | (02) |