Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | LT-3197 | NH |
NPI | 1205095825 |
---|---|
Provider Name | Dr. Sarah Ann Taylor-Black |
First Address | Keene, NH 03431-1719 |
Second Address | Keene, NH 03431-1719 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2008 |
Last Update Date | 11/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32001723 | (05) | NH |