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1144335126
GHISLAINE LAISSA OUEDRAOGO
RICHMOND, VA
NPI
1144335126
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: VA 0101239861)
Enumeration Date
2006-08-20
Last Update Date
2007-11-06
Business Address
GHISLAINE LAISSA OUEDRAOGO M. D.
12 N THOMPSON ST
RICHMOND, VA 23221-2718
Phone number: 804-359-9861
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Mailing Address
GHISLAINE LAISSA OUEDRAOGO M. D.
PO BOX 758963
BALTIMORE, MD 21275-8963
Phone number: 804-822-4355
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