Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 005374 | AZ |
NPI | 1164648226 |
---|---|
Provider Name | Dr. Lata Kumaraswamy |
First Address | Scottsdale, AZ 85258-4586 |
Second Address | Scottsdale, AZ 85258-4586 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 07/02/2013 |