Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 047519L | PA |
NPI | 1003853607 |
---|---|
Provider Name | Kathleen M Veloso |
First Address | Augusta, GA 30907-2464 |
Second Address | Philadelphia, PA 19107-6130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 08/07/2007 |