Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | MD473516 | PA |
NPI | 1134788557 |
---|---|
Provider Name | Mr. Marvin Herbert Braun |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-9800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2019 |
Last Update Date | 11/08/2021 |