Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 59046 | TN |
NPI | 1164802740 |
---|---|
Provider Name | Ms. Ruth Wang'ondu |
First Address | Memphis, TN 38105-3678 |
Second Address | Memphis, TN 38105-3678 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2015 |
Last Update Date | 27/01/2022 |