Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 27705 | MS |
NPI | 1083025324 |
---|---|
Provider Name | Lekha Sunkara Deere |
First Address | Clinton, MS 39056-5610 |
Second Address | Jackson, MS 39216-4500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2014 |
Last Update Date | 09/04/2021 |