Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | ME151458 | FL |
NPI | 1164727673 |
---|---|
Provider Name | Ciara Freeman |
First Address | Atlanta, GA 30384-8441 |
Second Address | Tampa, FL 33612-9416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2011 |
Last Update Date | 04/01/2022 |