Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | - | ZZ |
NPI | 1649884719 |
---|---|
Provider Name | Dr. Amal Y Elkhatib |
First Address | Dumfries, VA 22026-4534 |
Second Address | Dumfries, VA 22026-2202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2020 |
Last Update Date | 04/09/2020 |