Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | M1122 | TX |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | ME129510 | FL |
NPI | 1023070109 |
---|---|
Provider Name | Kristine Jane Guleserian |
First Address | Dallas, TX 75230-6906 |
Second Address | Miami, FL 33155-3009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 04/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
172724001 | (05) | TX |