Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 19969 | NV |
Y | 2080P0203X | Pediatric Critical Care Doctor | 19969 | NV |
NPI | 1275974693 |
---|---|
Provider Name | Dr. Tarun Malkani |
First Address | Madison, WI 53792-0001 |
Second Address | Madison, WI 53792-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2013 |
Last Update Date | 11/01/2021 |