Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 6685 | DC |
NPI | 1174639660 |
---|---|
Provider Name | Dr. Kathleen Bis |
First Address | Washington, DC 20037-1404 |
Second Address | Washington, DC 20037-1404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C87840 | (02) | DC |