Individual
CHRISTIAN TALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
790 FAIRVIEW AVE, APT 618, TAKOMA PARK, MD 20912-5979
(240) 271-6588
Mailing address
790 FAIRVIEW AVE, APT 618, TAKOMA PARK, MD 20912-5979
(240) 271-6588
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
IN00003758
NM
Other
Enumeration date
05/17/2014
Last updated
05/17/2014
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