Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 60916 | AZ |
NPI | 1447677307 |
---|---|
Provider Name | Nikita Goswami |
First Address | Roanoke, VA 24014 |
Second Address | Roanoke, VA 24014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2014 |
Last Update Date | 08/06/2020 |