Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 255590 | NY |
Y | 208000000X | Pediatrician | 255590 | NY |
NPI | 1033425004 |
---|---|
Provider Name | Juvianee Ibrahim Estrada-Veras |
First Address | Bethesda, MD 20892-0001 |
Second Address | Bethesda, MD 20892-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2010 |
Last Update Date | 12/04/2015 |