Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 0101247873 | VA |
NPI | 1003077587 |
---|---|
Provider Name | Dr. Jennifer Lynn Goodrich |
First Address | Bethesda, MD 20889-0001 |
Second Address | Bethesda, MD 20889-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2008 |
Last Update Date | 03/07/2013 |