Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | MD013942E | PA |
NPI | 1427320688 |
---|---|
Provider Name | Joseph J Trautlein |
First Address | Harrisburg, PA 17111 |
Second Address | Harrisburg, PA 17111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2012 |
Last Update Date | 03/02/2012 |