Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0208X | Pediatric Infectious Diseases | 252132 | NY |
Y | 2080P0208X | Pediatric Infectious Diseases | N4233 | TX |
NPI | 1598932410 |
---|---|
Provider Name | Omolara Violet Aderinboye |
First Address | Laredo, TX 78045-6423 |
Second Address | Laredo, TX 78045-6268 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2008 |
Last Update Date | 01/02/2010 |