Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 11449 | ND |
N | 207Q00000X | Family Doctor | MD429395 | PA |
NPI | 1003837964 |
---|---|
Provider Name | Rita Nalubega |
First Address | Devils Lake, ND 58301-3015 |
Second Address | Devils Lake, ND 58301-3015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2006 |
Last Update Date | 07/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1457426 | (05) | ND |