Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | D78127 | MD |
NPI | 1013204171 |
---|---|
Provider Name | Chantal Youssef |
First Address | Ellicott City, MD 21042-1253 |
Second Address | Ellicott City, MD 21042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2011 |
Last Update Date | 20/06/2018 |