Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | D91568 | MD |
NPI | 1013287820 |
---|---|
Provider Name | Bipasha Mukherjee-Clavin |
First Address | Middle River, MD 21220-2004 |
Second Address | Baltimore, MD 21224-2735 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2012 |
Last Update Date | 03/08/2021 |