Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 159063 | MA |
NPI | 1366677239 |
---|---|
Provider Name | Rohan Hazra |
First Address | Potomac, MD 20854-3333 |
Second Address | Bethesda, MD 20892-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2009 |
Last Update Date | 21/05/2009 |