Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 036146662 | IL |
NPI | 1255725289 |
---|---|
Provider Name | Dr. Sairah Thommi |
First Address | Jacksonville, FL 32256-7269 |
Second Address | New Orleans, LA 70112-2632 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2015 |
Last Update Date | 17/06/2021 |