Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | N4139 | TX |
NPI | 1003957812 |
---|---|
Provider Name | Dr. Aditi Jagdish Sule |
First Address | Austin, TX 78749-1902 |
Second Address | Austin, TX 78749-1902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2007 |
Last Update Date | 14/04/2017 |