Individual
SOO MIN SUMMER DEWENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-4001
Mailing address
2807 S WOODROW ST APT B, ARLINGTON, VA 22206-3321
(571) 275-0704
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001274958
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024180857
VA
Other
Enumeration date
01/28/2021
Last updated
01/28/2021
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