Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 044995 | GA |
NPI | 1134390453 |
---|---|
Provider Name | Dr. Daniele Sara |
First Address | Atlanta, GA 30305-3204 |
Second Address | Atlanta, GA 30327-2108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2008 |
Last Update Date | 13/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H92573 | (02) | GA |