Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | T3077 | TX |
N | 208200000X | Surgeon | 6084 | GA |
N | 208600000X | Surgeon | 6084 | GA |
NPI | 1063850196 |
---|---|
Provider Name | Trine L Engebretsen |
First Address | Dallas, TX 75265 |
Second Address | New Orleans, LA 70121-2429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2013 |
Last Update Date | 29/09/2021 |