Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 018679 | ME |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 018679 | ME |
NPI | 1669657532 |
---|---|
Provider Name | Lalaine C Llanto |
First Address | Brewer, ME 04412-1005 |
Second Address | Brewer, ME 04412-1005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2008 |
Last Update Date | 12/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
432814999 | (05) | ME |