Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | MD17189 | DC |
NPI | 1467756585 |
---|---|
Provider Name | Dr. Ellen Sidransky |
First Address | Bethesda, MD 20892-0001 |
Second Address | Bethesda, MD 20892-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2011 |
Last Update Date | 04/01/2011 |