Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | N3824 | TX |
Y | 2080P0204X | Pediatric Emergency Doctor | 51120 | CO |
NPI | 1033301759 |
---|---|
Provider Name | Roxanna Lefort |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2007 |
Last Update Date | 09/02/2021 |