Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0002X | Hospice and Palliative Medicine | 50297 | WI |
Y | 207RH0003X | Hematology & Oncology | 89952 | GA |
N | 207RX0202X | Medical Oncology | 50297 | WI |
NPI | 1215129085 |
---|---|
Provider Name | Dr. Ticiana B Leal |
First Address | Atlanta, GA 30322-1059 |
Second Address | Atlanta, GA 30322-1914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2007 |
Last Update Date | 08/09/2021 |