Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath |
NPI | 1972712255 |
---|---|
Provider Name | Dr. Premala E. Brewster-Wilson |
First Address | Silver Spring, MD 20906-2087 |
Second Address | Silver Spring, MD 20906-2087 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 08/07/2007 |