Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 22569 | GA |
NPI | 1003327214 |
---|---|
Provider Name | Jinal Achyutkumar Khamar |
First Address | Atlanta, GA 30309-3945 |
Second Address | Atlanta, GA 30309-1281 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2017 |
Last Update Date | 14/10/2017 |