Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 01445 | MD |
NPI | 1053451344 |
---|---|
Provider Name | Dr. Tasha Latrice Young |
First Address | Upper Marlboro, MD 20772-9343 |
Second Address | Upper Marlboro, MD 20772-9343 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 06/10/2014 |