Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 25278 | NE |
NPI | 1043472806 |
---|---|
Provider Name | Dr. Dustin Little |
First Address | Bethesda, MD 20889-0004 |
Second Address | Tacoma, WA 98431-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2008 |
Last Update Date | 30/06/2015 |