Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | RN210470 | GA |
NPI | 1003243494 |
---|---|
Provider Name | Mrs. Katherine Liang |
First Address | Atlanta, GA 30309-1316 |
Second Address | Atlanta, GA 30309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2013 |
Last Update Date | 16/06/2018 |