Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 19971 | OK |
NPI | 1568530137 |
---|---|
Provider Name | Cecilia Carubelli Guthrie |
First Address | Oklahoma City, OK 73104-5008 |
Second Address | Oklahoma City, OK 73104-4637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 04/05/2015 |