Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251H1200X | Hand |
NPI | 1023193398 |
---|---|
Provider Name | Mary Kathleen Sorenson |
First Address | Bowie, MD 20715-4031 |
Second Address | Bowie, MD 20715-4031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 08/07/2007 |