Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | 0110006605 | VA |
NPI | 1972169910 |
---|---|
Provider Name | Erin Bartlett |
First Address | Leesburg, VA 20175-6856 |
Second Address | Ashburn, VA 20148-6503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2019 |
Last Update Date | 15/05/2019 |