Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 223548 | MA |
NPI | 1003921784 |
---|---|
Provider Name | Marketa Van Den Elzen |
First Address | Vancouver, BC V6Z2Y2 |
Second Address | Vancouver, BC V6Z2Y2 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 08/07/2007 |