Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 08001784A | IN |
NPI | 1366859944 |
---|---|
Provider Name | Dr. Gina Lee Porter |
First Address | Cambridge City, IN 47327-1332 |
Second Address | Cambridge City, IN 47327-1332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2014 |
Last Update Date | 16/07/2014 |