Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | CHRI010425 | GA |
NPI | 1851985147 |
---|---|
Provider Name | Dr. Alisha Gaulden |
First Address | Marietta, GA 30064-5449 |
Second Address | Marietta, GA 30064-1979 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2021 |
Last Update Date | 26/02/2021 |