Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 0057502 | CO |
NPI | 1093030926 |
---|---|
Provider Name | Catherine Weng |
First Address | Broomfield, CO 80021-8252 |
Second Address | Broomfield, CO 80021-8252 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2010 |
Last Update Date | 30/03/2017 |