Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 0650390 | ZZ |
NPI | 1205220340 |
---|---|
Provider Name | Dr. Leslie Patricia Laing Gibbard |
First Address | Toronto, ONTARIO M4E 3L3 |
Second Address | Iowa City, IA 52242-1001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2015 |
Last Update Date | 26/03/2015 |