Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | R7401 | TX |
NPI | 1205196961 |
---|---|
Provider Name | Dr. Daniela Maria Burchhardt |
First Address | Concord, NH 03301 |
Second Address | Jamaica, NY 11418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2012 |
Last Update Date | 20/01/2020 |