Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | DRP1929 | FL |
NPI | 1861979908 |
---|---|
Provider Name | Maram Bawazir |
First Address | Gainesville, FL 32610-0414 |
Second Address | Gainesville, FL 32610-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2018 |
Last Update Date | 06/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DRP1929 | UNIVERSITY OF FLORIDA (01) | FL |