Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | 01011239127 | VA |
NPI | 1366495228 |
---|---|
Provider Name | Cristian Rodriguez |
First Address | Alexandria, VA 22302-1200 |
Second Address | Alexandria, VA 22302-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 08/07/2007 |