Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 200301493 | NC |
NPI | 1144254442 |
---|---|
Provider Name | Rowena Blas Mariano |
First Address | Charlotte, NC 28263-3362 |
Second Address | Durham, NC 27710-4000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 05/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H99232 | (02) |