Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | S03861 | MD |
N | 111NP0017X | Pediatric Chiropractor | S03861 | MD |
NPI | 1669825337 |
---|---|
Provider Name | Dr. Yetunde Oni |
First Address | Hyattsville, MD 20785-2365 |
Second Address | Hyattsville, MD 20785-2365 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2016 |
Last Update Date | 22/04/2021 |