Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD048187 | DC |
Y | 2080P0210X | Pediatric Nephrologist | MD048187 | DC |
NPI | 1205221975 |
---|---|
Provider Name | Lorena Botero Calderon |
First Address | Washington, DC 20010-2916 |
Second Address | Washington, DC 20010-2916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2015 |
Last Update Date | 06/07/2020 |