Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 00337AT | TX |
NPI | 1174724900 |
---|---|
Provider Name | Antoinette Marie Vandeputte |
First Address | El Paso, TX 79915-3805 |
Second Address | El Paso, TX 79915-3805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 08/07/2007 |