Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD438094 | PA |
Y | 2080P0201X | Pediatric Allergist | D80140 | MD |
NPI | 1689832800 |
---|---|
Provider Name | Maria Jimena Gutierrez |
First Address | Baltimore, MD 21264-4316 |
Second Address | Baltimore, MD 21287-0005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2008 |
Last Update Date | 15/09/2016 |