Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 80141 | GA |
NPI | 1083034045 |
---|---|
Provider Name | Dr. Diane Chien Lin Goh |
First Address | Marietta, GA 30060-1358 |
Second Address | Marietta, GA 30060-1358 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2014 |
Last Update Date | 04/05/2018 |