Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 234610 | MA |
N | 111NI0900X | Internist | 234610 | MA |
N | 207RH0000X | Hematologist | 234610 | MA |
Y | 207RH0003X | Hematology & Oncology | 234610 | MA |
N | 207RX0202X | Medical Oncology | 234610 | MA |
NPI | 1326174004 |
---|---|
Provider Name | Gabriela Motyckova |
First Address | Salt Lake City, UT 84143-0001 |
Second Address | Salt Lake City, UT 84103-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 29/05/2014 |