Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 0101033433 | VA |
NPI | 1174619613 |
---|---|
Provider Name | Dr. Laurie Joan Smith |
First Address | Silver Spring, MD 20906 |
Second Address | Washington, DC 20906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 08/07/2007 |