Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 0101246155 | VA |
N | 207KA0200X | Allergist | 0101246155 | VA |
NPI | 1013131010 |
---|---|
Provider Name | Dr. Darlene Mansoor |
First Address | Baltimore, MD 21297-3215 |
Second Address | Fairfax, VA 22031-2240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 01/05/2020 |