Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | D0063674 | MD |
NPI | 1124091582 |
---|---|
Provider Name | Ngozi Juliet Efobi |
First Address | Martinsburg, WV 25401-5843 |
Second Address | Hagerstown, MD 21740-5852 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I46978 | (02) |