Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | MD009514E | PA |
NPI | 1710954128 |
---|---|
Provider Name | Roslyn C Souser |
First Address | Ardmore, PA 19003-1021 |
Second Address | Bryn Mawr, PA 19010-1352 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B37572 | (02) | PA |