Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0700X | Prosthodontist | 150963 | NC |
Y | 1223P0700X | Prosthodontist | 32487 | TX |
NPI | 1083026181 |
---|---|
Provider Name | Dr. Karona Apsara Tum |
First Address | Chapel Hill, NC 27599-7450 |
Second Address | Conroe, TX 77304-2334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2014 |
Last Update Date | 13/01/2020 |