Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 079349 | GA |
NPI | 1003250796 |
---|---|
Provider Name | Adriana Gonzalez |
First Address | Roswell, GA 30076-2126 |
Second Address | Roswell, GA 30076-2126 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2013 |
Last Update Date | 04/06/2021 |