Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 227865 | MA |
Y | 2080P0204X | Pediatric Emergency Doctor | MD041285 | DC |
NPI | 1245285659 |
---|---|
Provider Name | Alyssa M Abo |
First Address | Baltimore, MD 21297-3215 |
Second Address | Washington, DC 20010-2916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 26/06/2013 |