Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | D17521 | MD |
NPI | 1003163072 |
---|---|
Provider Name | Dr. Karen Moss Ezrine |
First Address | Naples, FL 34119-2371 |
Second Address | Naples, FL 34119-2371 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2012 |
Last Update Date | 09/08/2012 |