Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | DI38534 | FL |
NPI | 1144525338 |
---|---|
Provider Name | Lisa L Decker Baumbach |
First Address | Miami, FL 33136-2137 |
Second Address | Miami, FL 33136-2137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2011 |
Last Update Date | 19/01/2011 |