Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 04-41561 | KS |
NPI | 1104232404 |
---|---|
Provider Name | Joy-Ann Tabanor-Gayle |
First Address | Englewood, NJ 07631-1808 |
Second Address | Topeka, KS 66606-1670 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2014 |
Last Update Date | 20/09/2019 |