Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0127X | Trauma Surgeon | C7-0005370 | DE |
NPI | 1114360872 |
---|---|
Provider Name | Kalpana Suresh |
First Address | Newark, DE 19718 |
Second Address | Newark, DE 19718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2013 |
Last Update Date | 25/06/2013 |