Individual
SUMITHA GAVINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0000
LA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
000
LA
Other
Enumeration date
10/12/2023
Last updated
10/12/2023
Update your record
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