Individual
JULITA MIR
Active
Individual
JULITA MIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
151010
MA
207RI0200X
Infectious Disease Physician
Primary
151010
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04903589
ECFMG
MA
05
—
3161455
—
MA
Enumeration date
03/24/2006
Last updated
08/22/2014
Update your record
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