Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 2284 | TN |
N | 207QG0300X | Family Doctor - Geriatric Medicine | FLOS8294 | FL |
NPI | 1235244450 |
---|---|
Provider Name | Monica Lynn Warhaftig |
First Address | Memphis, TN 38117-3802 |
Second Address | Memphis, TN 38117-3802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 11/08/2011 |