Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 0101236162 | VA |
N | 207U00000X | Nuclear Medicine Specialist | D0060486 | MD |
NPI | 1821011487 |
---|---|
Provider Name | Aaron Lehi Stack |
First Address | Gaithersburg, MD 20882-1448 |
Second Address | Washington, DC 20307-0003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 08/07/2007 |