Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | D0054068 | MD |
NPI | 1013127695 |
---|---|
Provider Name | Isabelle A Hertig |
First Address | Burtonsville, MD 20866-0299 |
Second Address | Rockville, MD 20852-3142 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F22562 | (02) |