Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NP-0051 | DC |
N | 175L00000X | Homeopath |
NPI | 1750795407 |
---|---|
Provider Name | Dr. Damilola Kemisola Familoni |
First Address | Upper Marlboro, MD 20772-4849 |
Second Address | Upper Marlboro, MD 20772-4849 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2014 |
Last Update Date | 30/06/2014 |