Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 329530 | LA |
NPI | 1275917023 |
---|---|
Provider Name | Sandra Guerguis |
First Address | Baton Rouge, LA 70816-6038 |
Second Address | Baton Rouge, LA 70809-3481 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2015 |
Last Update Date | 10/12/2021 |