Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | D67470 | MD |
NPI | 1215065537 |
---|---|
Provider Name | Julia G Rosselli |
First Address | Baltimore, MD 21264-2063 |
Second Address | Baltimore, MD 21201-1513 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 06/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
415090200 | (05) | MD |