Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | DC2266 | NM |
NPI | 1164002028 |
---|---|
Provider Name | Erin M Mauthe |
First Address | Rio Rancho, NM 87124-5986 |
Second Address | Rio Rancho, NM 87124-5986 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2021 |
Last Update Date | 13/04/2021 |