Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 2010-01600 | NC |
NPI | 1063607901 |
---|---|
Provider Name | Ekta Shah |
First Address | Charlotte, NC 28219-9305 |
Second Address | Charlotte, NC 28210-8538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2007 |
Last Update Date | 30/09/2021 |