Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 0401410318 | VA |
NPI | 1063424026 |
---|---|
Provider Name | Navin Hukmani |
First Address | Leesburg, VA 20176-8472 |
Second Address | Leesburg, VA 20176-8472 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 08/07/2007 |