Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | D82198 | MD |
NPI | 1184067514 |
---|---|
Provider Name | Vijaya Lakshmi Alla |
First Address | Rockville, MD 20852-4908 |
Second Address | Temple Hills, MD 20748 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2013 |
Last Update Date | 23/06/2021 |