Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | MD15607 | DC |
NPI | 1083708176 |
---|---|
Provider Name | Bruce Klein |
First Address | Middle River, MD 21220-2004 |
Second Address | Washington, DC 20010-2978 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 29/11/2021 |