Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 0101237864 | VA |
NPI | 1093897597 |
---|---|
Provider Name | Anita Nanda Wasan |
First Address | Mc Lean, VA 22102-2324 |
Second Address | Lansdowne, VA 20176-6820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 24/09/2016 |