Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | D0080658 | MD |
NPI | 1093016149 |
---|---|
Provider Name | Anne Elizabeth Wyman |
First Address | Columbia, MD 21044-2912 |
Second Address | Brooklyn, NY 11203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2010 |
Last Update Date | 24/06/2019 |