Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | 9111860 | FL |
NPI | 1487127973 |
---|---|
Provider Name | Ms. Simona Dobos |
First Address | Little Rock, AR 72225-1420 |
Second Address | Little Rock, AR 72205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2019 |
Last Update Date | 01/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102188900 | (05) | FL |