Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 81-196 | NM |
N | 207RG0300X | Geriatric Medicine | 81196 | NM |
NPI | 1134108236 |
---|---|
Provider Name | Lakshmi Ganga |
First Address | Albuquerque, NM 87113-1761 |
Second Address | Albuquerque, NM 87113-1761 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2006 |
Last Update Date | 16/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11981 | (05) | NM |
D35645 | (02) | |
D35645 | (02) | NM |