NPI Profile for QYHDIJHA IVY in SCOOBA, MS.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Neonatal Intensive Care |
163WN0002X |
| NPI # | 1427784164 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 07/26/2022 | |
| Last updated | 07/26/2022 - About 4 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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QYHDIJHA IVY
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