Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 89-345 | NM |
NPI | 1043225592 |
---|---|
Provider Name | Diane Hanfelt-Goade |
First Address | Albuquerque, NM 87106-4374 |
Second Address | Albuquerque, NM 87131-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2006 |
Last Update Date | 08/03/2011 |