Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | MD.202176 | LA |
NPI | 1821282369 |
---|---|
Provider Name | Amanda Gayle Brown |
First Address | New Orleans, LA 70118-5720 |
Second Address | New Orleans, LA 70118-5720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2007 |
Last Update Date | 01/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
23916 | (05) | LA |