Individual
JOSE GUSTAVO ESPINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6866 DEER RUN DR, ALEXANDRIA, VA 22306-1124
(703) 307-8999
Mailing address
6866 DEER RUN DR, ALEXANDRIA, VA 22306-1124
(703) 307-8999
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA0191
DC
363AS0400X
Surgical Physician Assistant
—
MD
Other
Enumeration date
04/14/2016
Last updated
04/14/2017
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