Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 0101241302 | VA |
NPI | 1023237997 |
---|---|
Provider Name | Shawana Mufti |
First Address | Fairfax, VA 22030-0991 |
Second Address | Fairfax, VA 22030-2917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 09/05/2016 |