Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 0420015285 | VT |
N | 207RA0201X | Internist - Allergy & Immunology | D0088951 | MD |
NPI | 1477973568 |
---|---|
Provider Name | Olga Hardin |
First Address | South Burlington, VT 05403-5201 |
Second Address | South Burlington, VT 05403-5201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2014 |
Last Update Date | 10/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6707809 | (05) | VT |