Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | PENDING | CA |
NPI | 1043711559 |
---|---|
Provider Name | Andree-Anne Leclerc |
First Address | Pittsburgh, PA 15222-5630 |
Second Address | San Francisco, CA 94115-3465 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2018 |
Last Update Date | 21/02/2018 |