Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 036.129814 | IL |
NPI | 1477902740 |
---|---|
Provider Name | Eva Zaklubera |
First Address | Davenport, IA 52807-2125 |
Second Address | Moline, IL 61265-6118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2016 |
Last Update Date | 08/06/2016 |