Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 036.150928 | IL |
Y | 207U00000X | Nuclear Medicine Specialist | 312065-01 | NY |
NPI | 1114420304 |
---|---|
Provider Name | Dr. Khushboo Gupta |
First Address | New York, NY 10029 |
Second Address | New York City, NY 10029 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2018 |
Last Update Date | 31/08/2021 |