Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | AG02180067 | MD |
NPI | 1063912079 |
---|---|
Provider Name | Tricia Patel |
First Address | Baltimore, MD 21231-3215 |
Second Address | Baltimore, MD 21224-6821 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2018 |
Last Update Date | 16/02/2018 |