Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251E1300X | Electrophysiology, Clinical | 19268 | MD |
Y | 2251E1300X | Electrophysiology, Clinical | J1-0002084 | DE |
NPI | 1003941592 |
---|---|
Provider Name | Ms. Lisa Hope Goodfriend |
First Address | Wilmington, DE 19808-2740 |
Second Address | Wilmington, DE 19805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2007 |
Last Update Date | 08/07/2007 |