Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | D40764 | MD |
N | 208000000X | Pediatrician | E69606 | MD |
NPI | 1043277049 |
---|---|
Provider Name | Nancy Elise Braverman |
First Address | Baltimore, MD 21264-4316 |
Second Address | Baltimore, MD 21287-0006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E69606 | (02) | MD |