Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | MD418267 | PA |
NPI | 1093887200 |
---|---|
Provider Name | Maribelle Gauna-Estrada |
First Address | Erie, PA 16504-2009 |
Second Address | Erie, PA 16504-2009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 05/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G62141 | (02) | PA |