Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 83111 | SC |
NPI | 1235496076 |
---|---|
Provider Name | Johanna Bailey Von Hofe |
First Address | Greenville, SC 29615-4536 |
Second Address | Greenville, SC 29605-4281 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2012 |
Last Update Date | 17/09/2019 |