Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | A-2100-17 | NM |
NPI | 1023274131 |
---|---|
Provider Name | Renee Marie Triplet |
First Address | Depew, NY 14043-4114 |
Second Address | Albuquerque, NM 87106-4930 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2008 |
Last Update Date | 27/06/2019 |