Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MT197293 | PA |
N | 208600000X | Surgeon | MT197293 | PA |
Y | 2086X0206X | Surgical Oncologist | 59953 | TN |
NPI | 1023338688 |
---|---|
Provider Name | Laura M Enomoto |
First Address | Nashville, TN 37241-8159 |
Second Address | Knoxville, TN 37920-1555 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2010 |
Last Update Date | 19/04/2021 |