Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | ME97013 | FL |
NPI | 1770664054 |
---|---|
Provider Name | Wacharee Seeherunvong |
First Address | Miami, FL 33136-1005 |
Second Address | Miami, FL 33136-1005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 22/11/2011 |