Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0000X | Obstetrician | MW010207 | PA |
NPI | 1285956276 |
---|---|
Provider Name | Kathleen Agnes Brummer Torres |
First Address | Philadelphia, PA 19107-5176 |
Second Address | Philadelphia, PA 19107-5176 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2010 |
Last Update Date | 16/10/2019 |