Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | D79041 | MD |
NPI | 1063737773 |
---|---|
Provider Name | Katherine S Perry |
First Address | Bowie, MD 20716-3104 |
Second Address | Bowie, MD 20716-3104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2010 |
Last Update Date | 24/10/2016 |