Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | ME96190 | FL |
Y | 2084N0400X | Neurologist | ME96190 | FL |
N | 2084N0600X | Clinical Neurophysiologist | ME96190 | FL |
NPI | 1154469120 |
---|---|
Provider Name | Hildegarde Geisse |
First Address | Fort Lauderdale, FL 33309-2114 |
Second Address | Fort Lauderdale, FL 33309-2114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 04/04/2019 |