Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 0401414770 | VA |
NPI | 1033553052 |
---|---|
Provider Name | Ashley Abesamis Harman |
First Address | Midlothian, VA 23112-4281 |
Second Address | Midlothian, VA 23112-4281 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2013 |
Last Update Date | 31/05/2016 |