Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | A73808 | CA |
NPI | 1003881525 |
---|---|
Provider Name | Dr. Robin Lyn Bird |
First Address | Fpo, AE 09589 |
Second Address | Fpo, AE 09589 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2006 |
Last Update Date | 08/07/2007 |