Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | MD463857 | PA |
NPI | 1003234949 |
---|---|
Provider Name | Dr. James Light |
First Address | Sellersville, PA 18960-1548 |
Second Address | Sellersville, PA 18960-1548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2014 |
Last Update Date | 28/10/2021 |