Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 0101244102 | VA |
NPI | 1003046384 |
---|---|
Provider Name | Dr. Sivapriya Ramakrishnan |
First Address | Tucson, AZ 85750-1262 |
Second Address | Tucson, AZ 85712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2009 |
Last Update Date | 16/11/2012 |