Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DD3543 | NM |
NPI | 1194013805 |
---|---|
Provider Name | Dr. Darren Carl Norby |
First Address | Albuquerque, NM 87111-2087 |
Second Address | Albuquerque, NM 87111-2087 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2011 |
Last Update Date | 14/07/2011 |