Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | ME0036825 | PA |
NPI | 1053596874 |
---|---|
Provider Name | Jonathan D Ralph |
First Address | Plantation, FL 33317-2385 |
Second Address | Plantation, FL 33317-2385 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2007 |
Last Update Date | 31/12/2007 |