Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | S2008 | TX |
NPI | 1699181966 |
---|---|
Provider Name | Alma Rosibel Cruz |
First Address | Baton Rouge, LA 70808-4300 |
Second Address | Baton Rouge, LA 70806-7851 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2014 |
Last Update Date | 20/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2367510 | (05) | LA |