Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | D80488 | MD |
NPI | 1407288525 |
---|---|
Provider Name | Esther Mena Gonzalez |
First Address | Baltimore, MD 21287-0006 |
Second Address | Baltimore, MD 21287-0006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2013 |
Last Update Date | 13/10/2017 |