Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 0024177208 | VA |
NPI | 1104382860 |
---|---|
Provider Name | Ms. Ann Marie Smoot |
First Address | Aldie, VA 20105-5837 |
Second Address | Aldie, VA 20105-5837 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2019 |
Last Update Date | 18/02/2019 |