Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD13638 | RI |
Y | 2080P0204X | Pediatric Emergency Doctor | D0077963 | MD |
NPI | 1235422445 |
---|---|
Provider Name | Therese Canares |
First Address | Baltimore, MD 21287-0010 |
Second Address | Baltimore, MD 21287-0010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2011 |
Last Update Date | 28/07/2014 |