Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 222383 | MA |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | DR.0056107 | CO |
NPI | 1073788915 |
---|---|
Provider Name | Dr. Leslie Kayo Winter |
First Address | Longmont, CO 80501-3128 |
Second Address | Longmont, CO 80501-3128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2008 |
Last Update Date | 25/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110082628A | (05) | MA |
99730090 | (05) | CO |