Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 374U00000X | DC |
NPI | 1912324310 |
---|---|
Provider Name | Joy Ezirim |
First Address | Washington, DC 20005 |
Second Address | Washington, DC 20005-2500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2014 |
Last Update Date | 24/03/2014 |