Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD2015-0743 | NM |
Y | 2080P0205X | Pediatric Endocrinologist | MD2015-0743 | NM |
NPI | 1154557635 |
---|---|
Provider Name | Dr. Maria Corazon Sta Ana Hizon |
First Address | Albuquerque, NM 87125-6666 |
Second Address | Albuquerque, NM 87106-4922 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2009 |
Last Update Date | 14/12/2015 |