Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | R142889 | MD |
NPI | 1386967545 |
---|---|
Provider Name | Rita Abu-Jaber |
First Address | Baltimore, MD 21264-4664 |
Second Address | Baltimore, MD 21287-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2010 |
Last Update Date | 30/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
420192200 | (05) | MD |