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Individual
RAQUEL INNISS
Active
Individual
RAQUEL INNISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD074296
PA
208000000X
Pediatrics Physician
MD074296
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01951255
—
PA
Enumeration date
06/07/2006
Last updated
08/11/2022
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