Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | R1364 | TX |
NPI | 1083010060 |
---|---|
Provider Name | Ifeoma Anthonia Egbuonu |
First Address | El Paso, TX 79912-5919 |
Second Address | El Paso, TX 79938 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2014 |
Last Update Date | 15/08/2018 |