Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251H1200X | Hand | OC000258L | PA |
NPI | 1609985001 |
---|---|
Provider Name | Mrs. Deborah A Humbert |
First Address | Media, PA 19063-5104 |
Second Address | Media, PA 19063-5104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |