Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | D0064507 | MD |
N | 207RH0000X | Hematologist | D0064507 | MD |
NPI | 1003121096 |
---|---|
Provider Name | Dr. Nicole Jeanine Gormley |
First Address | Bethesda, MD 20892-0001 |
Second Address | Bethesda, MD 20892-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2010 |
Last Update Date | 13/08/2010 |