Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 0024180944 | VA |
NPI | 1114510955 |
---|---|
Provider Name | Mariam Alimi |
First Address | Herndon, VA 20171-5352 |
Second Address | Fairfax, VA 22030-7175 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2021 |
Last Update Date | 12/02/2021 |