Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 02005109A | IN |
Y | 2080P0203X | Pediatric Critical Care Doctor | 02005109A | IN |
NPI | 1184948986 |
---|---|
Provider Name | Elizabeth Nocera |
First Address | Indianapolis, IN 46290-1024 |
Second Address | Indianapolis, IN 46260-1902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2010 |
Last Update Date | 13/06/2017 |