Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 0101263012 | VA |
NPI | 1164733960 |
---|---|
Provider Name | Marta Biderman Waberski |
First Address | Mc Lean, VA 22101-2322 |
Second Address | Fairfax, VA 22031-2241 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2010 |
Last Update Date | 19/10/2020 |