Individual
AMRI NGOYE MALIYATABU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9401 MATHY DRIVE SUITE 350, FAIRFAX, VA 22031
(240) 426-8271
Mailing address
9401 MATHY DR STE 350, FAIRFAX, VA 22031-5333
(240) 426-8271
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
DC
Other
Enumeration date
06/06/2012
Last updated
06/17/2014
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