Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | A117624 | CA |
NPI | 1063558682 |
---|---|
Provider Name | Miss Ani Balmanoukian |
First Address | Baltimore, MD 21202-2278 |
Second Address | Baltimore, MD 21287-0005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 02/07/2012 |