Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | MT196761 | PA |
NPI | 1164741781 |
---|---|
Provider Name | Dr. Denita Marie Boschulte |
First Address | York, PA 17402-4620 |
Second Address | York, PA 17403-3676 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2010 |
Last Update Date | 10/06/2014 |