Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 46053 | MN |
Y | 2084N0402X | Child Neurologist | 49061 | WI |
NPI | 1245200708 |
---|---|
Provider Name | Hema R. Murali |
First Address | Marshfield, WI 54449-5703 |
Second Address | Marshfield, WI 54449-5703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 30/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
34888400 | (05) | WI |
647674100 | (05) | MN |
H91964 | (02) |