Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A144932 | CA |
N | 111NI0900X | Internist | A144932 | CA |
Y | 207RR0500X | Rheumatology | A144932 | CA |
NPI | 1003202714 |
---|---|
Provider Name | Audra Horomanski |
First Address | Stanford, CA 94305-2200 |
Second Address | Stanford, CA 94305-2200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2015 |
Last Update Date | 29/11/2021 |