Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 9379 | NV |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 9379 | NV |
NPI | 1033300611 |
---|---|
Provider Name | Marirose Cutillar |
First Address | Carson City, NV 89701-1215 |
Second Address | Carson City, NV 89706-0147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2007 |
Last Update Date | 01/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H21296 | (02) |