Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 0104001719 | VA |
NPI | 1619127214 |
---|---|
Provider Name | Dr. Peter Gilson Hilgartner |
First Address | Leesburg, VA 20175-2635 |
Second Address | Leesburg, VA 20175-2635 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2008 |
Last Update Date | 19/09/2008 |