Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 2017-02119 | NC |
NPI | 1063761351 |
---|---|
Provider Name | Kashmira Pramod Wankhedkar |
First Address | Charlotte, NC 28260-0447 |
Second Address | Charlotte, NC 28204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2012 |
Last Update Date | 28/10/2020 |