Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | 25MA10872900 | NJ |
Y | 207VX0000X | Obstetrician | 25MA10872900 | NJ |
NPI | 1073976445 |
---|---|
Provider Name | Victoria Eugenia Guerrero Gorman |
First Address | Burlington, NJ 08016-4722 |
Second Address | Burlington, NJ 08016-4722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2016 |
Last Update Date | 15/09/2020 |