Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | A-2254-19 | NM |
NPI | 1659711943 |
---|---|
Provider Name | Deborah Ds Whitson |
First Address | Las Cruces, NM 88001-6056 |
Second Address | Las Cruces, NM 88001-6056 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2013 |
Last Update Date | 17/05/2019 |