Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 170100000X | Medical Geneticist |
NPI | 1104411693 |
---|---|
Provider Name | Dr. Jaclyn B Murry |
First Address | Baltimore, MD 21287-0005 |
Second Address | Baltimore, MD 21287-0005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2021 |
Last Update Date | 05/03/2021 |