Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 0010-11178 | NC |
NPI | 1083295273 |
---|---|
Provider Name | Hailey Rebecca Einck |
First Address | Medford, OR 97504-9113 |
Second Address | Medford, OR 97504-9113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2021 |
Last Update Date | 19/04/2021 |