Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 0101240095 | VA |
NPI | 1336119189 |
---|---|
Provider Name | Dr. Sushma Sanjay Hirani |
First Address | Oakton, VA 22124-1761 |
Second Address | Oakton, VA 22124-1761 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 06/02/2017 |