Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | MD020122E | PA |
NPI | 1033219795 |
---|---|
Provider Name | Marie Blanche Lim |
First Address | Philadelphia, PA 19107-1511 |
Second Address | Philadelphia, PA 19107-1503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2006 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000761050 | (05) | PA |