Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 21034 | NH |
NPI | 1073771515 |
---|---|
Provider Name | Dr. Jung-Woo Ma |
First Address | Erie, PA 16506-7201 |
Second Address | Concord, NH 03301-2551 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2008 |
Last Update Date | 07/05/2021 |