Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | ME0080464 | FL |
NPI | 1083697320 |
---|---|
Provider Name | Pardeep Kumari |
First Address | Pensacola, FL 32524 |
Second Address | Pensacola, FL 32514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 27/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
258918400 | (05) | FL |
H17284 | (02) |