Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | MT200365 | PA |
Y | 208000000X | Pediatrician | MT200365 | PA |
NPI | 1699060277 |
---|---|
Provider Name | Louise Pyle |
First Address | Philadelphia, PA 19104-4399 |
Second Address | Philadelphia, PA 19104-4399 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2011 |
Last Update Date | 13/06/2011 |