Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A120549 | CA |
N | 208600000X | Surgeon | A120549 | CA |
Y | 2086X0206X | Surgical Oncologist | D76504 | MD |
NPI | 1285952028 |
---|---|
Provider Name | Kelly Jeanne Lafaro |
First Address | Baltimore, MD 21236-4902 |
Second Address | Baltimore, MD 21287-0005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2010 |
Last Update Date | 18/09/2019 |