Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 9918 | MD |
NPI | 1053484345 |
---|---|
Provider Name | Dr. Debra Z. Ehudin |
First Address | Pikesville, MD 21208-1300 |
Second Address | Pikesville, MD 21208-1392 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 08/07/2007 |