Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 90108 | NM |
NPI | 1003900499 |
---|---|
Provider Name | Thomas Rothfeld |
First Address | Albuquerque, NM 87125-6666 |
Second Address | Albuquerque, NM 87108-2921 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 15/07/2008 |