Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 0101243234 | VA |
NPI | 1003073677 |
---|---|
Provider Name | Dr. Julia Lottie Krulla |
First Address | Haymarket, VA 20169 |
Second Address | Haymarket, VA 20169-2996 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 28/12/2009 |