Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 71666 | WI |
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | MD60403568 | WA |
N | 207RC0000X | Internist - Cardiovascular Disease | 71666 | WI |
N | 207RC0000X | Internist - Cardiovascular Disease | MD60403568 | WA |
NPI | 1053465658 |
---|---|
Provider Name | Sofia Carolina Masri |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 21/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1053465658 | (05) | WA |