Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 5995 TEP | NE |
Y | 111NI0900X | Internist | 5995 TEP | NE |
NPI | 1003047564 |
---|---|
Provider Name | Dr. Vidhya Murukesan |
First Address | Omaha, NE 68131-2137 |
Second Address | Omaha, NE 68131-2137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2009 |
Last Update Date | 01/08/2009 |