Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 0101262446 | VA |
Y | 207RX0202X | Medical Oncology | 0101262446 | VA |
NPI | 1063701852 |
---|---|
Provider Name | Louise M Man |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22908-0817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2011 |
Last Update Date | 08/10/2020 |