Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | HOO64991 | MD |
NPI | 1033328539 |
---|---|
Provider Name | Dr. Yvette Ju |
First Address | Baltimore, MD 21208-1095 |
Second Address | Hyattsville, MD 20783-3245 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 08/07/2007 |