Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | N0001741 | MD |
NPI | 1235709148 |
---|---|
Provider Name | Nana T Vincent |
First Address | Lanham, MD 20703-0122 |
Second Address | Lanham, MD 20706-2265 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2021 |
Last Update Date | 01/07/2021 |