Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 47497 | TN |
NPI | 1386811891 |
---|---|
Provider Name | Dr. Kathleen Nicole Montinola Jalandoni |
First Address | Memphis, TN 38104-3627 |
Second Address | Memphis, TN 38104-3627 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2008 |
Last Update Date | 16/02/2013 |