Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0201X | Gynecologic Oncologist | 01069785B | IN |
Y | 207VX0201X | Gynecologic Oncologist | 200901878 | NC |
NPI | 1215198080 |
---|---|
Provider Name | Emma Caroline Rossi |
First Address | Indianapolis, IN 46202 |
Second Address | Greensboro, NC 27403-1118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2008 |
Last Update Date | 20/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201032370 | (05) | IN |