Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | OS003555L | PA |
NPI | 1801136627 |
---|---|
Provider Name | Dr. E Joan Graham |
First Address | Plymouth, PA 18651-2508 |
Second Address | Plymouth, PA 18651-2508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2013 |
Last Update Date | 15/02/2013 |