Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 015254 | LA |
NPI | 1700066289 |
---|---|
Provider Name | Carolyn Beach Daul |
First Address | Metairie, LA 70006-2931 |
Second Address | Metairie, LA 70006-2931 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2007 |
Last Update Date | 20/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00111022 | (05) | MS |
1330388 | (05) | LA |
B60772 | (02) | LA |