Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CHIR009410 | GA |
NPI | 1942691142 |
---|---|
Provider Name | Angela Maria Gabella |
First Address | Atlanta, GA 30342-2572 |
Second Address | Atlanta, GA 30342-2572 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2015 |
Last Update Date | 17/12/2015 |