Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251C2600X | Cardiopulmonary | P13765 | NC |
NPI | 1124793120 |
---|---|
Provider Name | Sara Uribe Dorn |
First Address | Durham, NC 27705-3888 |
Second Address | Durham, NC 27705-3888 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2021 |
Last Update Date | 11/08/2021 |