Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | MD13741 | ME |
NPI | 1003895715 |
---|---|
Provider Name | Sandra L Harris |
First Address | Albany, NY 12201-1638 |
Second Address | Lewiston, ME 04240-6045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 12/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D39180 | (02) | ME |