Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 13440 | SC |
N | 2080P0208X | Pediatric Infectious Diseases | 13440 | SC |
NPI | 1467405886 |
---|---|
Provider Name | Robin Newton Lacroix |
First Address | Greenville, SC 29615-4536 |
Second Address | Greenville, SC 29615-3580 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 18/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
APPROVED | (05) | SC |