Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 49392 | KY |
N | 207RR0500X | Rheumatology | BP10049117 | TX |
NPI | 1063705432 |
---|---|
Provider Name | Dr. Archana Srinivas |
First Address | Chicago, IL 60677-6351 |
Second Address | Louisville, KY 40207-0000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2011 |
Last Update Date | 18/08/2016 |