Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251C2600X | Cardiopulmonary | P15632 | NC |
NPI | 1700484011 |
---|---|
Provider Name | Michelle Grace Iorio |
First Address | Durham, NC 27705-2671 |
Second Address | Durham, NC 27705-2671 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2020 |
Last Update Date | 09/10/2020 |