Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 1045318 | DC |
NPI | 1376067967 |
---|---|
Provider Name | Ms. Candace Mary Willett |
First Address | Washington, DC 20037-1449 |
Second Address | Washington, DC 20037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2017 |
Last Update Date | 13/07/2018 |