Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD0000049585 | TN |
NPI | 1497982003 |
---|---|
Provider Name | Lisa Haresh Jambusaria |
First Address | Nashville, TN 37203-5180 |
Second Address | Nashville, TN 37203-2220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2009 |
Last Update Date | 08/04/2021 |