Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 56810 | TN |
NPI | 1073036232 |
---|---|
Provider Name | Miriam Wing San Tsao |
First Address | Memphis, TN 38148-0001 |
Second Address | Memphis, TN 38104-3415 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2017 |
Last Update Date | 01/08/2019 |